health law: practitioner recruitment

Practitioner Recruitment

Kim C. Stanger

(7/14)

Overview• Laws affecting recruitment arrangements

– Stark– Anti-kickback statute– Tax laws– State laws

• Applying the laws to common recruitment arrangements– Employment– Independent contractors– Recruitment agreements

• Retention requirements• Common terms in arrangements• Suggestions for compliance

• Physicians• Midlevels

Preliminaries

• Written materials.– .ppt slides– Stark recruitment and retention safe harbors– Stark commentary for recruitment and retention safe

harbors– Anti-Kickback Statute recruitment safe harbor– OIG Supplemental Compliance Program Guidance for

Hospitals– OIG Adv. Op. 01-4– IRS Health Care Provider Reference Guide

• Presentation will be recorded and available for download at www.hhhealthlawblog.com.

• If you have questions, please submit them using chat line or e-mail me at [email protected].

http://www.hollandhart.com/

mailto:[email protected]

Preliminaries• This presentation is similar to any other legal

education materials designed to provide general information on pertinent legal topics. The statements made as part of the presentation are provided for educational purposes only. They do not constitute legal advice nor do they necessarily reflect the views of Holland & Hart LLP or any of its attorneys other than the speaker. This presentation is not intended to create an attorney-client relationship between you and Holland & Hart LLP. If you have specific questions as to the application of law to your activities, you should seek the advice of your legal counsel.

• Anytime you give anything to or deal with a potential referral source, beware…–Anti-kickback statute–Stark statute

• And don’t forget–Tax laws–State laws

Laws Affecting Recruitment Arrangements

• In 2003, Prosecutors indicted Tenet Alvarado Medical Center, its CEO, and others for Anti-Kickback Statute violations, alleging:– Defendants paid $10-$15 million to “recruit”

100 physicians between 1992 and 2002.– Many of the deals resulted in money flowing to

existing physician practices.– Arrangements were allegedly a sham to funnel

money to physicians in exchange for referrals.

United States v. Weinbaum (San Diego)

• Assistant Administrator pled guilty to conspiracy.– 3 years probation– $27,000 fine

• CEO and Tenet went through two trials, both of which resulted in hung juries.– Hospital reportedly spent $30,000,000 in

defending cases• After govt threatened Medicare exclusion,

Tenet settled.– Paid $21,000,000– Sold hospital

United States v. Weinbaum

• Be careful when entering recruitment agreements, especially if it involves existing physician practices.

United States v. Weinbaum

Ethics in Patient Referrals Act (“Stark”)

• 42 USC 1395nn• 42 CFR 411.351

et seq.

• Physicians cannot refer a patient to an entity with which the physician (or their family member) has a financial relationship if the referral is for designated health services (“DHS”) for which payment may be made under Medicare, and

• Entities cannot submit a bill for payment for DHS rendered pursuant to a proscribed referral,

• Unless the transaction fits within a regulatory safe harbor.

Stark

• No criminal penalties.• Denial of payment for services.• Repayment of money received from

government and patient for items or services rendered per improper referrals during period of noncompliance.

• Civil monetary penalty if fail to repay within 60 days of prohibited referral: – Up to $15,000 for each service.– Up to $100,000 for each scheme.

• Exclusion from Medicare/Medicaid.• May trigger False Claims Act.

Stark

Stark

• Only applies to financial arrangements with referring physicians or their family members.– MD, DO, DPM, DMD, DDS, OD, DC– Spouse, parent, child, sibling, stepparent, stepchild, in-

law, grandparent, grandchild.• Does not apply to recruitment of non-physicians.– PA, NP, CRNA, etc.– CMS declined to extend the exception to midlevels.

• May apply if recruitment benefits referring physicians.– E.g., subsidize recruitment of midlevel into physician

office.

• Stark safe harbors potentially applicable to recruitment arrangements.– Employment– Personal services– Physician recruitment– Physician retention– Indirect compensation– EHR donations– OB malpractice insurance– Ownership or investment interest in rural

provider– Services by another physician in the group or

in-office ancillary service exception– Others?

• Need only satisfy one safe harbor.

Stark: Safe Harbors

Anti-Kickback Statute

• 42 USC 1320a-7(b)• 42 CFR 1001.952

• Cannot knowingly and willfully solicit, offer, pay, or receive remuneration in exchange for referring an individual for items or services covered by federal health care programs (e.g., Medicare, Medicaid, etc.)

• Unless structure transaction to fit within a regulatory safe harbor or obtain favorable advisory opinion.

• Applies if “one purpose” of the transaction is to induce improper referrals. (U.S. v. Greber , 760 F. 2d 68 (3rd Cir. 1985))


• Criminal penalties– 5 years in prison– $25,000 fine per violation.

• Civil penalties– 3x illegal kickback– $50,000 per violation. – Automatic exclusion from Medicare/Medicaid.

• Anti-Kickback Statute violation = False Claims Act violation– $5,500 - $11,000 per claim submitted– 3x damages– Qui tam lawsuits

• May be used to void contracts.


• Safe harbors potentially applicable to recruitment or retention situations include—– Employment– Personal services– Recruitment– OB malpractice insurance

subsidy– EHR donations– Others?

• Need only satisfy one safe harbor.

AKS: Safe Harbors

Tax Issues

• Section 501(c)(3) exempts charitable nonprofit corporations from federal taxation.

• To maintain tax-exempt status, must be operated for– Public benefit– NOT private benefit

• Excessive payments to private practitioners = private benefit.

• May result in loss of tax-exempt status.

Tax:Private Benefit

• Allows IRS to impose excise tax on value of excess benefit that organization provides to disqualified persons.– 25% excise tax– 200% excise tax if not corrected within

specified time– 10% excise tax capped at $20,000 on

organization manager• Disqualified persons = persons who exercise

substantial control over organization, including—– Officers, directors, trustees– Perhaps physicians, especially if serve as chief

of staff, medical director, etc.(IRC 4958)

Tax: Excess Benefit and Intermediate Sanctions

• Payments to recruit physicians are evaluated on case by case basis considering:– Demonstrated community need for the

practitioner.– Total recruitment package is reasonable in light of

facts and circumstances.– Hospital board approved or oversees recruitment

arrangement.– Arrangements do not violate fraud and abuse laws.– Entire agreement memorialized in single written

agreement that is negotiated at arm’s length, i.e., no undocumented side agreements.

(See also Private Letter Ruling dated 7/31/98)

Tax Issues:IRS Revenue Ruling 97-21

• Recruitment incentives should be—– Based on community need• NOT necessarily hospital need

– Provided as part of arms-length transaction– Consistent with written policies– Not result in excessive compensation to

physician (e.g., unreasonable income guarantees)

– Legal

IRS Health Care Provider Reference Guide

State Laws

• Anti-kickback statutes• Self-referral statutes• For public entities:– Prohibitions against using public funds

for private individuals.– Prohibitions against loaning public

money.• Others?

Some possible state laws to consider

Applying Laws to Arrangements

Employment Agreement: StarkStark employment safe harbor applies if:• Bona fide employment of physician or family member.• Employment for identifiable services.• Agreement would be commercially reasonable even if

no referrals were made.• Remuneration is:

– Consistent with fair market value, and– Not determined in manner that takes into account

(directly or indirectly) volume or value of referrals.• May pay productivity bonus based on services

performed personally by physician or family member.(42 CFR 411.357(c))

Employment Agreement: AKS

• AKS does not apply to bona fide employees.

(42 CFR 1001.952(i)).– Payment to induce referrals may not be “bona

fide” employment.• Bona fide employee depends on IRS 20-

factor test, e.g, – Right of control– Paid hourly or by job– Withholding of taxes– Furnishing of equipment– Furnishing of subcontractors– Etc.

Employment Agreement: Tax

• Recruitment incentives are generally subject to employment taxes, e.g.,– Relocation reimbursement– Signing bonuses– Student loan repayments– Forgivable loans– Others

• Tax-exempt non-profit: – Document FMV.– IRS Info Letter 02-0021: sets forth factors

considered by IRS in valuing compensation paid to physician by tax-exempt hospitals.

Independent Contractors: Stark

Stark personal services safe harbor applies if:• Written agreement signed by parties for services between

entity and physician or family member.• Agreement for at least one year. If terminated, cannot enter

substantially the same arrangement within the 1-year period.• Agreement covers services furnished by physician or family

member.• Aggregate services do not exceed those reasonable and

necessary for legitimate business purposes.• Compensation is set in advance, does not exceed fair market

value, and is not determined in a manner that takes into account the volume or value of referrals.

• Services do not involve counseling or promotion of illegal arrangements or acts.

(42 CFR 411.357(d))

Independent Contractors: Stark

Stark fair market value safe harbor applies if:• Written agreement signed by parties for identifiable services.• Agreement specifies length of time, which can be for any

period of time provided the parties enter only one agreement for the same services within 1 year. Arrangement for less than 1 year may be renewed any number of times so long as the terms and compensation do not change.

• Compensation is set in advance, does not exceed fair market value, and is not determined in a manner that takes into account the volume or value of referrals.

• Arrangement is commercially reasonable and furthers the legitimate purposes of the parties.

• Arrangement does not violate the Anti-Kickback Statute.• Services do not involve counseling or promotion of illegal

arrangements or acts.

(42 CFR 411.357(l))

Independent Contractors: AKSAKS personal services safe harbor applies if:• Written agreement signed by parties.• Agreement for at least 1 year.• Agreement specifies all services to be performed by practitioner.• If practitioner is to perform services on periodic or part-time

basis, the agreement must specify the schedule, length, and charge for such intervals.

• Aggregate compensation must be set in advance, consistent with fair market value, and not determined in a manner that takes into account volume or value of Medicare/Medicaid referrals.

• Aggregate services do not exceed those that are reasonably necessary to accomplish commercially reasonable business purpose.

• Services do not involve counseling or promotion of business arrangement or activity that violates any state or federal law.

(42 CFR 1001.952(d))

Independent Contractors: AKS

• If you cannot fit within the AKS safe harbor:– Ensure there is no improper intent to

generate referrals.• Beware discussions.• Beware documentation.

– Come as close as you can to the safe harbor requirements.

– Document community need.– Document fair market value paid for

services actually performed.

Independent Contractors: Tax

• Payments identified in form 1099.• Tax-exempt non-profit: – Document FMV.– IRS Info Letter 02-0021: sets forth

factors considered by IRS in valuing compensation paid to physician by tax-exempt hospitals.

Recruitment Agreement• One-time payment of recruitment incentive.• Payment expenses.

– Student loan– Relocation expenses– Practice start up expenses– Recruiter fees– Insurance

• Income guarantee.• Providing items or services to support recruit.

– Space or equipment.– Information technology.– Administrative support.– Marketing.

• Others?

Stark recruitment safe harbor applies if:• Payments by hospital, FQHC, or RHC.• Relocate to hospital’s geographic service area (as

defined in regulations) and join medical staff. Relocate medical practice =– Move at least 25 miles into the service area, or– At least 75% or revenues come from services to new

patients (as defined in the regulations).Except for resident or physician who has been in practice less than 1 year, certain former govt employees, or obtain advisory opinion.

• Written agreement signed by parties.• Not conditioned or based on referrals to hospital.• Not restricted from making referrals to or having med

staff membership in other entities except as allowed by 42 CFR 411.354(d)(4).

Recruitment Agreement: Stark

(42 CFR 411.357(e))

If recruit into existing practice, must also satisfy following for Stark safe harbor—• Agreement signed by all parties, including practice.• Remuneration paid to or passed through to recruited physician except for

actual recruitment costs incurred by practice.– E.g., headhunter fees, airfare, lodging, etc., but not time spent by

practice.• If income guarantee, limit allocated costs to actual incremental costs

attributable to recruited physician.– Generally cannot subsidize existing overhead.

• If recruited to replace physician in rural area or HPSA, costs allocated to recruited physician may be:– Actual additional incremental costs, or– Lower of per capita allocation or 20% of the practice’s aggregate costs.

• Records of costs and passed through amounts maintained for 5 years and available to HHS upon request.


(42 CFR 411.357(e))

If recruit into existing practice, must also satisfy following for Stark safe harbor:• Remuneration not determined based on referrals by recruited

physician or physician practice• Practice may not impose practice restrictions that unreasonably

restrict physician’s ability to practice in geographic area. The following are permitted:– Reasonable restrictive covenants consistent with state law.– Restrictions on moonlighting.– Prohibitions on soliciting patients or employees.– Confidentiality provisions.– Requiring physician to repay losses to practice.– Liquidated damages if physician leaves practice.(72 FR 51053; CMS AO-2011-01)

• Arrangement does not violate the AKS.


(42 CFR 411.357(e))

Stark recruitment safe harbor does not apply if—• Recruitment payments by entity other than

hospital, RHC or FQHC.– E.g., recruitment by group, nursing home, HHAs, etc.

• Physician already on medical staff.– E.g., active, courtesy, telemedicine?, etc.

• Physician relocates within geographic service area unless physician is a resident, practicing less than 1 year, or previously employed by federal agency.

• Recruitment of non-physician.– E.g., joint recruitment of midlevel.


• Beware changing terms of the agreement after the physician arrives.– “The purpose of the physician recruitment exception is to

permit certain compensation arrangements to induce a physician to relocate his or her medical practice to the geographic area served by a hospital in order to become a member of the hospital’s medical staff. We do not believe that the parties should now be able to amend the Arrangement to provide for additional (or potentially additional) compensation to the Physician. Because the Physician has already relocated to the his medical practice, the additional compensation is not for the purpose of inducing relocation and may directly or indirectly reflect the volume or value of the recruited physician’s actual or potential referrals.”

(CMS-AO-2007-01)


(42 CFR 411.357(e))

AKS safe harbor applies if—• Payment to induce practitioner who has either been practicing for

less than 1 year, or a practitioner who will relocate, to HPSA served by the entity;

• Written agreement signed by parties specifying terms;• At least 75% of revenues come from new patients;• At least 75% of revenues from HPSA, MUA, or MUP;• Benefits provided for no more than 3 years;• Terms not renegotiated within the 3-year period;• Cannot require referrals to entity paying remuneration, but may

require practitioner to maintain medical staff membership at entity;• Cannot prohibit referrals to or medical staff membership at other

entities;• Benefits are not based on referrals for federal program business;• Must agree to treat govt health program beneficiaries in

nondiscriminatory manner; and• Cannot benefit another entity in a position to generate referrals

(e.g., cannot recruit into an existing group).

Recruitment Agreement: AKS

(42 CFR 1001.952(n))

• AKS recruitment safe harbor does not apply if—– Recruit to area that is not a HPSA .– Recruit for practitioner other than general or

family practice, general internal medicine, pediatrics, or obstetrics and gynecology.

– Recruit into existing practice or joint recruitment.

• But remember—– Failure to satisfy safe harbor does NOT mean

that the statute is violated.– No violation if no purpose is to generate

referrals.* Document community need!


(OIG Supplemental Hospital Compliance Program Guidance, 70 FR 4868; see also OIG Adv. Op. 01-4)

• Community need may be documented by:– Community designated as HPSA.– Population ratio in community for particular

specialty is below recommended or standard ratios.– Demand for particular medical service +

documented lack of service or long waiting periods.– Anticipated reduction in number of physicians due

to anticipated retirement in next few years.– Demonstrated reluctance of physicians to relocate

to area.– Evidence of lack of physicians serving indigent or

Medicaid patients in the service area.– Other?


• Entities should consider factors such as—– The size and value of recruitment benefit.• Does the benefit exceed what is reasonably

necessary to attract a qualified practitioner?• Has facility previously tried and failed to

recruit or retain physician?– The duration of payout of the recruitment

benefit.• Total benefit payout periods extending

longer than 3 years are suspect.– Whether the remuneration directly or indirectly

benefits other referral sources.



• Entities should consider factors such as—– The practice of existing practitioner.• Is physician new with few or no patients?• Is physician relocating from substantial

distance so referrals unlikely to follow him?• Does the physician have an existing stream

of referrals in the service area?– The need for the recruitment.• Is recruited physician’s specialty needed for

adequate care in the community?• Do patients already have access to

comparable services in or near the community?



Beware joint recruitment deals with group practices.

• Recruitment benefits may be way to buy referrals from existing group practice, e.g., – Build outs or improvements that benefit

physician group.– Subsidies or income guarantees that shift

overhead or costs from physician group to recruiting entity.

• Remember United States v. Weinbaum!



Recruiting Midlevels

Recruiting Midlevels: AKS

• AKS applies to recruiting midlevels if they will refer federal program business.– Satisfy AKS applicable safe harbor, e.g., • Employment• Independent contractor• Recruitment agreement

or– Document community need.

Recruiting Midlevels: Stark

• Stark does not apply to or prohibit payments made directly to recruited midlevel unless:– Midlevel is a conduit for physician referrals, or– Midlevel is a member of a referring physician’s family.

• Stark may apply if payments subsidize a physician practice’s costs of recruiting and employing midlevels.– Creates financial relationship with group.– CMS declined to extend the recruitment safe harbor to

midlevels.(72 FR 51049)• Be careful when recruiting midlevels into referring

physician group!

Retaining Practitioners

Practitioner Retention: AKS• There is no AKS safe harbor for practitioner

retention.• Try to fit within another safe harbor (e.g.,

employment or independent contractor).• Ensure there is no improper intent to

generate referrals.– Beware discussions– Beware documentation

• Document community need.• Document fair market value, i.e., paying

appropriate amount to keep the physician there.

Physician Retention: Stark

Stark retention safe harbor requires:• Payment by hospital, FQHC, or RHC directly to

physician on medical staff to retain physician’s practice in the hospital’s, RHC’s or FQHC’s geographic service area.

• Area served by hospital, FQHC, or RHC is either:– A HPSA (regardless of physician’s specialty), or– Has demonstrated need for the physician per

HHS advisory opinion.• At least 75% of patients reside in a MUA or are

members of a MUP.

(42 CFR 411.357(t))


Stark retention safe harbor requires:• If physician has a bona fide firm, written

recruitment offer from other entity:– Offer requires physician to move practice at least

25 miles and outside geographic area served by hospital

– Retention payment subject to same obligations and restrictions on repayment or forgiveness of indebtedness as contained in the offer.

– Retention payment does not exceed the lower of—• Amount obtained by subtracting current

income from the offer, or• Reasonable costs hospital would have to

recruit new physician.(42 CFR 411.357(t))


Stark retention safe harbor requires:• If physician provides written certification of bona fide

employment opportunity:– Opportunity requires physician to move practice at

least 25 miles and outside geographic area served by hospital;

– Certification details opportunity, steps taken by physician to effect the opportunity, date of relocation, and info sufficient to verify opportunity.

– Hospital takes reasonable steps to verify opportunity.– Retention payment does not exceed the lower of—

• 25% of physician’s current income, or• Reasonable costs hospital would have to recruit new

physician.

(42 CFR 411.357(t))

Physician Retention: StarkStark retention safe harbor also requires:• Retention arrangement is set out in writing and signed by both

parties.• Retention arrangement is not conditioned on physician’s referrals.• Retention remuneration not based on the volume or value of

referrals.• Physician is allowed to establish staff privileges and refer

business to other entities except as allowed by 42 CFR 411.354(d)(4).

• Hospital does not enter retention arrangement with the physician more frequently than once every 5 years.

• Amount and terms of retention payment are not altered during term of arrangement in any manner based on the volume or value of referrals.

• Arrangement does not violate the AKS.

(42 CFR 411.357(t))


• If cannot fit within the exception,– Look for another safe harbor.• Employment contract.• Independent contractor.• Fair market value exception.

– Obtain an advisory opinion. • CMS stated that it would consider retention

arrangements through the advisory opinion process. (See 69 FR 16097)

Practitioner Retention: Tax

• IRS has not addressed retention payments.• Retention payments probably okay if

satisfy essentials of Revenue Ruling 97-21, e.g.,– Documented community need.– Written agreement negotiated at arms length.– Payments reasonable under the circumstances.– Adequate board supervision.– Retention payments must not violate fraud and

abuse laws.

Common Recruitment Terms


• Written agreement signed in advance by all parties.– Entity, recruited practitioner, and group.

• Define practice requirements.– Relocate to geographic area served by entity.– Maintain fulltime practice in specialty in community

for defined period of time, e.g., 3 years.– Maintain medical staff membership at entity.– Call obligations– If recruited into group, consider situation in which

practitioner leaves group but remains in community.• Define qualifications.


• Include terms required by safe harbors, e.g.,– Do not discriminate against govt program

beneficiaries.– No referral requirement.– Maintain documentation.– Make records available to HHS.

• Beware imposing unreasonable or impermissible practice restrictions.– Noncompetes, unless as part of an employment

agreement.– Prohibition against establishing medical staff

privileges or referring business to other entities.


• Define benefits, e.g.,– Signing bonus– Relocation reimbursement– Student loan repayment– Practice assistance– Free or subsidized rent or equipment– Income guarantee– Other?

• Account for tax ramifications.• Condition benefits on compliance with agreement

terms, including practice requirements and qualifications.

Common Recruitment Terms• Income guarantee.

– Usually structured as: Maximum monthly guarantee amount- Net income (all income – additional incremental expenses) Income guarantee payment

– Identify qualifying “additional incremental expenses”– Cap on duration of income guarantee.

• Usually 1 year.– Cap on total and monthly guarantee payments.

• Income guarantee terminates if cap is met.– Reconciliation or termination if income exceeds

guarantee in relevant time period.– Require documentation to support payments.– Require good faith efforts and sound business practices.

Common Recruitment Terms• Allow termination upon specified occurrences, e.g.,

– Failure to maintain fulltime practice in the community.– Failure to maintain qualifications, e.g.,

• Loss or restriction in licensure.• Loss or restriction of medical staff membership.• Exclusion from Medicare, Medicaid or govt contracts.• Loss of insurance.

– Determination that arrangement violates applicable law, jeopardizes tax exempt status, prohibits entity from billing for services referred by practitioner, or may subject the parties to adverse action by regulatory agency.

• Require immediate notice of failure to satisfy conditions or qualifications.

• Confirm benefits and obligations cease upon termination.


• Repay benefits if fail to maintain fulltime practice in the community for certain period of time or otherwise breach terms of arrangement.– Repayment structured as penalty.

• Repay penalty plus interest.– Benefits structured as a forgivable loan.

• Loan forgiven if fulfills terms of agreement.• Promissory note.• Security interest, e.g., group revenues.• Consider tax consequences.• Note: public entities may be limited in ability to loan money.

– Repay entire benefits or prorated portion.– Repayment by physician and/or group.

Avoiding Recruitment Problems


• Beware subsidizing existing practices through recruitment agreements.– Remember Weinbaum?

• Only recruit practitioners if there is a legitimate and documented community need.– See OIG and IRS Guidance.

• Define terms of recruitment arrangement in advance.– Reimbursement to group of recruitment expenses.– Payments made to recruited physician.– Remember: you must comply with the agreed terms.

• Do not pay more than is reasonably necessary to get the recruit to your service area.

Avoiding Recruitment Problems• For physicians, ensure you comply with Stark safe

harbor and, to the extent possible, the AKS safe harbor.– Compare contract terms to safe harbor requirements.– Require review by compliance officer or competent counsel.

• For non-physicians, ensure you comply with AKS safe harbor to extent possible.– Compare contract terms to safe harbor requirements.– Require review by compliance officer or competent counsel.

• Beware joint recruitment arrangements.– Additional Stark requirements.– No AKS safe harbor.

• Consider tax implications of any benefits paid to the recruit.


• Strictly comply with terms of the agreement.– Ensure recruit performs according to terms of agreement.– Do not alter, renegotiate, or waive terms after the recruit

arrives.– Do not overpay.– Obtain and maintain documentation for compliance.– Periodically review compliance.– Audit payments as necessary.

• Terminate the arrangement for noncompliance and obtain repayment consistent with terms of the agreement.

If you think you have a problem

• Do not do this!

If you think you have a problem• Stark

– Cannot bill for services referred by physician or group.– Must repay amounts received from improper referrals.– $15,000 per improper referral

• Anti-Kickback Statute– $25,000– Up to 5 years in prison– $50,000 administrative penalty

• False Claims Act– $5,500 to $11,000 per claim– 3x damages– Exclusion from Medicare/Medicaid

• Must repay overpayment within 60 days or else it becomes a False Claims Act violation.


• Suspend submitting claims by referring physician until situation resolved.– Knowingly submitting false claim = False Claims Act

violation.• Involve compliance officer or competent counsel to

review the situation.– Compliance with fraud and abuse laws.– Scope of potential improper payments.

• Make necessary corrections.– Repayments from practitioner.– Enforce contract terms.– Modify policies or processes to avoid problems in the future.

• Determine if report and repayment is necessary.


• If repayment is required, consider appropriate process for self-disclosure.– CMS Self-Referral Disclosure Protocol.

• Applies to Stark violations.– OIG Self-Disclosure Protocol.

• Applies to AKS and False Claims Act violations.– Report and repay to contractor within 60 days.

• See relevant contractor’s webpage.• No guarantee that govt will go easier, but you

are safer than if you fail to report.– Cuts off ongoing liability.– Cuts off threat of qui tam litigation.

Additional Resources

https://oig.hhs.gov/compliance/

OIG Website

• Compliance 101 series• OIG Compliance Program Guidance– OIG Supplemental Compliance Program Guidance

for Hospitals, 70 FR at 4863-69– OIG Compliance Program Guidance for Physicians

• Advisory Opinions• Special Fraud Alerts• Fraud Bulletins• Letters• Other materials

Additional Holland & Hart Resources

• Past webinars are available at www.hhhealthlawblog.com

• Future webinars– Health Law Basics monthly webinar series– 7/24 Employee Benefits for Healthcare Providers– 8/7 Dealing with Disruptive Practitioners– 8/28 Intellectual Property Issues for Healthcare

Entities– 9/11 Healthcare Reform Update– 9/25 Environmental Law Issues for Healthcare

Entities• Healthcare Update and Health Law Blog

– Under “Publications” at www.hollandhart.com.– E-mail me at [email protected].

http://www.hhhealthlawblog.com/

http://www.hollandandhart.com/


Questions?

Kim C. StangerHolland & Hart LLP

(208) [email protected]

