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Advisory Opinions 2001 Archive

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2001

11-26-2001
Advisory Opinion No. 01-21 (PDF)
(concerning a medical center's proposed acquisition of an ownership interest in an operating ambulatory surgical center that is currently owned by a group of gastroenterologists.)
11-21-2001
Advisory Opinion No. 01-20 (PDF)
(concerning a payment arrangement between a Medicare-certified hospice and certain nursing facilities for services provided to residents of such facilities who are eligible both for Medicaid and Medicare hospice benefits ("Dually Eligibles"). Specifically, for Dually Eligibles, the hospice pays the nursing facilities the full Medicaid nursing facility per diem rate for non-hospice patients, which covers pharmacy services, plus a separate payment for drugs used by Dually Eligibles in connection with their terminal illness. You have asked whether such an arrangement would constitute grounds for the imposition of sanctions under the exclusion authority at section 1128(b)(7) of the Social Security Act (the "Act") or the civil monetary penalty provision at section 1128A(a)(7) of the Act, as those sections relate to the commission of acts described in section 1128B(b) of the Act.)
11-21-2001
Advisory Opinion No. 01-19 (PDF)
(concerning a hospital's proposed donation of free office space to an entity that provides free end-of-life services to patients with terminal illnesses. Specifically, whether that donation would constitute grounds for the imposition of sanctions under the exclusion authority at section 1128(b)(7) of the Social Security Act (the "Act") or the civil monetary penalty provision at section 1128A(a)(7) of the Act, as those sections relate to the commission of acts described in section 1128B(b) of the Act.)
11-7-2001
Advisory Opinion No. 01-18 (PDF)
(concerning an exclusive contract for emergency ambulance services between County A, State B and Medical Center C under which County A has assumed the obligation to pay otherwise uncollected coinsurance amounts on behalf of County A residents. Specifically, whether such an arrangement would constitute grounds for the imposition of sanctions under the exclusion authority at section 1128(b)(7) of the Social Security Act (the "Act") or the civil monetary penalty provision at section 1128A(a)(7) of the Act, as those sections relate to the commission of acts described in section 1128B(b) of the Act, or under the civil monetary penalties provision for illegal remuneration tobeneficiaries at section 1128A(a)(5) of the Act.)
10-17-2001
Advisory Opinion No. 01-17 (PDF)
(concerning whether an existing ambulatory surgical center ("ASC") joint venture between a hospital-affiliated entity and an entity owned indirectly by five ophthalmologists, together with the execution of three related ancillary agreements (the "Arrangement"), constitutes grounds for the imposition of sanctions under the exclusion authority at section 1128(b)(7) of the Social Security Act (the "Act") or the civil monetary penalty provision at section 1128A(a)(7) of the Act, as those sections relate to the commission of acts described in section 1128B(b) of the Act).
10-05-2001
Advisory Opinion No. 01-16 (PDF)
(concerning a managed care organization's employment of an excluded individual and potential sanctions under section 1320a-7a(a)(6) of the SSA)
09-27-2001
Advisory Opinion No. 01-15   (PDF)
(concerning a managed care organization's proposal to subsidize the Medicare+Choice premiums andcopayments of its members eligible for both Medicare and certain limited Medicaid benefits...)
09-04-2001
Advisory Opinion No. 01-14 (PDF)
(concerning a hospital's policy of waiving out-of-pocket copayments and deductibles for screening services and certain follow-up services that the hospital offers to promote early detection of breast and gynecological cancers.
08-24-2001
Advisory Opinion No. 01-13 (PDF)
(concerning the "coordination of benefits" provisions of a provider agreement between ... a health maintenance organization or "HMO", and the skilled nursing facilities in its provider network (the "Nursing Facilities"...)
08-24-2001
Final Notice of Modification of OIG Advisory Opinion No. 98-5 (PDF)
(concerning Advisory Opinion No. 98-5, which was issued on 04/17, 1998. In OIG Advisory Opinion No. 98-5, we concluded that the Requestor's contract with a managed care organization (in particular, its coordination of benefits provision, hereafter the "COB provision") could violate the anti-kickback statute, and we could not conclude that the COB provision posed little or no risk of Federal health care program fraud and abuse.
07-26-2001
Advisory Opinion No. 01-12 (PDF)
(concerning an exclusive contract between a city and an ambulance company for the provision of emergency medical services for city residents that includes a requirement that the contracting ambulance company waive out-of pocket Medicare copayments for city residents...)
07-26-2001
Advisory Opinion No. 01-11 (PDF)
(concerning a municipal corporation that owns and operates an ambulance service and that treats the operating revenues received from local taxes as payment of otherwise applicable copayments and deductibles due from the residents...)
07-26-2001
Advisory Opinion No. 01-10 (PDF)
(concerning a political subdivision of a State that owns and operates an ambulance service and that treats the operating revenues received from local taxes as payment of otherwise applicable copayments and deductibles due from the residents...)
07-26-2001
Advisory Opinion No. 01-09 (PDF)
(concerning a proposed grant from a hospital to a community health center to defray the costs of providing services to uninsured patients...)
07-10-2001
Advisory Opinion No. 01-8 (PDF)
(...concerns a comprehensive program that a manufacturer of therapeutic mattresses and other support services markets and sells to State-licensed nursing facilities to manage pressure ulcers...)
07-03-2001
Advisory Opinion No. 01-7 (PDF)
(concerning the practice of accepting reimbursement from third-party payors plus certain payments...)
05-29-2001
Advisory Opinion No. 01-6 (concerning "payments by vendors to a group purchasing organization (GPO) owned by entities affiliated with health care providers that purchase items covered by the GPO's vendor contracts."
05-23-2001
Advisory Opinion No. 01-5 (PDF)
(concerning "a proposed lease of cardiac diagnostic equipment to emergency medical services providers for a nominal charge.")
05-10-2001
Advisory Opinion No. 01-4 (PDF)
(concerning "a proposed arrangement between a hospital and a new physician whom the hospital would like to recruit to practice within its service area.")
05-10-2001
Advisory Opinion No. 01-3 (PDF)
(concerning "whether proposed contracts for discounted services between a Federally-recognized Indian tribe and local hospitals would constitute grounds for the imposition of exclusions under section 1128(b)(7) of the Act or civil money penalties under section 1128A(a)(7) of the Act.")
03-27-2001
Advisory Opinion No. 01-2 (PDF)
(concerning an annual charity golf tournament for which some of its vendors and suppliers pay money as sponsors and tournament participants...)
01-18-2001
Advisory Opinion No. 01-1 (PDF)
(concerning a proposed arrangement in which a hospital will share with a group of cardiac surgeons a percentage of the hospital's cost savings...)

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