Employee Bonuses for Procedures: HHS Issues Favorable Advisory Opinion

Anti-Kickback statute violations are the most common violations that result in heavy DOJ fines, penalties and even jail time. Knowing the scope and limitations of the AKS is vital to the growth of any company.

On October 10, 2023 the OIG issued Advisory Opinion No. 23-07 determining that bonuses paid to physicians employed in a 11 physician multi-specialty practice was not a violation of the Anti-Kickback Statute.

Anti-Kickback Statute Experts

“Each and every payment arrangement must be analyzed for AKS compliance”

-Ronald W. Chapman II, ESQ, LLM

In the proposed arrangement, the practice would pay the employed physician 30% collections of certain procedures preformed. This would be paid out as a quarterly bonus to the employed physician. According to HHS in the advisory opinion, the arrangement does not implicate the Anti-Kickback statute because it falls within the employee safe harbor which is an exception to the Anti-Kickback statute.

Click here to learn more about the Stark and Anti-Kickback Statute.

Health care attorneys will not find this analysis surprising because this arrangement has traditionally been found to be compliant. However, employee bonus programs have been scrutinized by federal prosecutors in health care fraud cases across the country and used to support conspiracy charges against owners of practices that have engaged in alleged overfilling and health care fraud.

CCG stresses that each and every payment arrangement must be scrutinized for legal compliance to ensure that it does not violate the Anti-Kickback statute. If you would like a free compliance checkup to spot potential compliance pitfalls - contact CCG Healthcare today.