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OIG Sees No Bar To Pathology Lab Volunteering In Medical Assistance Program


HLD, v. 32, n. 7 (July 2004)

OIG Sees No Bar To Pathology Lab Volunteering In Medical Assistance Program

An arrangement in which a pathology lab would provide services to low-income, uninsured patients through a charitable foundation's medical assistance program on a voluntary basis would not generate prohibited remuneration under the Anti-Kickback Statute, the Department of Health and Human Services (DHHS) Office of Inspector General (OIG) concluded in an advisory opinion released June 9.

The non-profit tax-exempt foundation runs a coordinated system of volunteer physician care, hospital care, diagnostic services, and medication assistance for low-income, uninsured residents in a certain county. To qualify for assistance, patients must reside in the county, have no medical insurance, be ineligible for government medical assistance, and have incomes that do not exceed 150% of the federal poverty level.

The pathology lab, a for-profit corporation partially owned by several pathologists, wants to volunteer its services to the program. The laboratory certified that no remuneration would be provided directly or indirectly to any volunteer physician, the volunteer pathology lab, or the pathologists performing the laboratory services. The lab also certified that its participation in the program was unrelated to any non-program business.

The OIG concluded that the proposed arrangement involving the pathology lab "results in no economic value to any party in a position to refer Federal health care program business to the Lab. Rather, the economic benefit of the Lab's participation inures to the public good in the form of increased availability of services for an underserved population."

Advisory Opinion No. 04-05 (Dep't Health & Human Servs. Office of Inspector Gen. June 2, 2004).

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