“But isn’t the “company model” illegal? Didn’t the Office of Inspector General (OIG) say that it was a kickback?” On June 1, 2012, the Department of Health and Human Services, OIG posted Advisory Opinion 12-06 (AO 12-06) in which it found that a “company model” arrangement and a management services arrangement raised concerns under the federal Anti-Kickback Statute oig.hhs.gov/fraud/docs/advisoryopinions/2012/AdvOpn12-06.pdf. Following issuance of that advisory opinion, many anesthesiologists thought that “company model” arrangements had been declared illegal and that referring physicians no longer would propose such arrangements.
The situation is, however, far more complex. This article will provide a brief overview of post-AO 12-06 developments and the continuing demands that anesthesiologists face to share their professional fees with referring physicians as a condition to receiving referrals from such physicians.
The “company model” defined: A traditional “company model” arrangement is one in which referring physicians create a separate “anesthesia company” that contracts...
