HHS Inspector General says on-call pay for ED is OK

Hospitals everywhere must be thrilled, given their ongoing concerns over how to manage the growing shortage of specialists in emergency departments. The HHS inspector general's office has just issued a letter concluding that a hospital's plan to pay doctors for on-call coverage in its ED isn't likely to serve as a channel for kickbacks.

While the letter applies only to the requesting hospital--a 400-bed facility that is the only acute-care provider in its county and is having trouble getting on-call support--it gives other hospitals reason for optimism that they can safely pay on-call specialists, too.

The unnamed hospital has proposed to pay doctors fixed sums of money--such as $350 for a surgical procedure--when the physicians are forced to treat uninsured patients. Without such payments, administrators note, they've gone weeks each month when they don't have necessary specialists on call.

In the letter, chief counsel to the inspector general Lewis Morris agrees that sometimes hospitals legitimately need to pay for on-call coverage. He warns that if payments aren't structured correctly, they could be used to hide kickbacks, but says that fair-market payments for specific services to the uninsured seem appropriate.

To learn more about the HHS IG's conclusions:
- read this Modern Healthcare piece [1] (reg. req.)

Related Articles:
EMTALA flexibility proposed to relieve on-call MD shortages [2]
On-call payments for ED coverage challenged [3]
MA hospitals bow to on-call pay trend [4]
Trend: On-call shortage closing trauma departments [5]