On-call payments for ED coverage challenged

Increasingly, hospitals are looking at paying specialists to provide on-call coverage for their emergency departments. However, it looks like a new advisory opinion issued by the HHS inspector general could throw a spike into these arrangements, adding yet another complication to increasingly tense specialist-hospital relationships.

The opinion letter, by IG chief counsel Lewis Morris, was spurred by a medical center's request for a ruling on its on-call compensation program. Morris cleared the medical center's program because a) payments were based on fair market value, b) the program served a defined need and c) the program was available to all physicians, rather than a favored few. He also noted that generally speaking, having a specialist on-call could be legal if done to meet EMTALA requirements or cope with physician shortages.

However, Morris also suggested that such programs could conceivably violate anti-kickback statutes. He said that there was a "considerable risk" that doctors would begin to demand on-call pay in return for referring patients to a hospital.

To find out more about the HHS IG opinion:
- read this Modern Physician article

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