AHCA has put out guidance regarding the Office of Inspector General (OIG)’s advisory opinion on e-referral systems, which indicates that certain contracts for hospital patient referrals to post-acute care providers may violate the federal anti-kickback law. AHCA is advising that providers review your current contracts and contact those companies to ask for an unqualified legal opinion from their attorneys to ensure that the contract does not currently violate the federal anti-kickback law.

AHCA has provided a form letter for you to use to begin that discussion, with special thanks to Jon Dolan (state executive, MHCA) and Harvey Tettlebaum (MHCA general counsel) for sharing the attached MHCA template letter. In the meantime, AHCA is working with the National Association for Home Care and Hospice and the American Hospital Association to put additional pressure on the referral companies that most of our members currently use. They hope to send out a joint letter by the end of the week.

Background Information:
The Office of Inspector General (OIG) recently released an advisory opinion on a referral service vendor that acts as a third party to coordinate referrals between acute-care hospitals and SNFs. Both providers pay a fee to the third party. SNFs who do not pay a fee can participate, but they do not get timely referrals because those referrals are faxed instead of quickly communicated to providers using the subscriber software. According to AHCA this is a hot issue, in part, because the model is so simple and there is very little (if anything) to distinguish the problematic model described in the Advisory Opinion from the models used by Allscripts and Curaspan. What’s most troublesome in respect to this Advisory Opinion is that SNFs use these referral systems to attract patients and many members currently have long-term contracts with these referral entities.

Toby Pearson
952.851.2480
tpearson@careproviders.org

Resources

Our Sponsors