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Advisory Opinions

In accordance with section 1128(D)(b) of the Social Security Act (42 U.S.C. 1320a-7d(b)) and 42 CFR part 1008, OIG issues advisory opinions about the application of OIG's fraud and abuse authorities to the requesting party's existing or proposed business arrangement. As required by the statute, these advisory opinions are being made available to the public through this OIG Web site.

One purpose of the advisory opinion process is to provide meaningful advice on the application of the anti-kickback statute and other OIG sanction statutes in specific factual situations. Please note, however, that advisory opinions are binding and may legally be relied upon only by the requestor. Since each opinion will apply legal standards to a set of facts involving certain known persons who provide specific statements about key factual issues, no third parties are bound nor may they legally rely on these advisory opinions.

We have redacted specific information regarding the requestor and certain privileged, confidential, or financial information associated with the individual or entity, unless otherwise specified by the requestor.

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Advisory Opinions for 2012

Advisory Opinion 12-22
(concerning an arrangement in which a hospital pays a cardiology group compensation that includes a performance bonus based on implementing certain patient service, quality, and cost savings measures associated with procedures performed at the hospital's cardiac catheterization laboratories.)
Advisory Opinion 12-21
(concerning a Federally qualified health center's proposal to offer grocery store gift cards to certain patients in capitated managed care plans as an incentive to receive health screenings or other clinical services.)
Advisory Opinion 12-20
(concerning a hospital's proposal to provide free access to an electronic interface to community physicians and physician practices that would allow those physicians and practices to transmit orders for certain services to, and receive the results of those services from, the hospital.)
Advisory Opinion 12-19
(concerning four proposed arrangements involving a pharmacy company's provision of items and services to community homes in which its customers reside.)
Advisory Opinion 12-18
(concerning a proposed arrangement whereby three municipalities will reciprocally waive the otherwise applicable cost-sharing obligations of each other's bona fide residents when providing backup emergency medical services transportation to such individuals in certain circumstances.)
Advisory Opinion 12-17
(concerning a proposal for a hospice to establish a volunteer program to provide non-skilled services to terminally ill patients who do not qualify for hospice care.)
Advisory Opinion 12-16
(concerning a proposal to waive cost-sharing amounts on a non-routine, unadvertised basis for insured patients, including Federal health care program beneficiaries, based on individualized determinations of financial need.)
Advisory Opinion 12-15
(concerning an existing arrangement under which a hospital pays a per diem fee to physicians for providing on-call coverage for the hospital's emergency department.)
Advisory Opinion 12-14
(concerning a rewards program under which consumers would earn gasoline discounts based on the amount they spend on purchases in retail supermarkets, including cost-sharing amounts paid in connection with items covered by Federal health care programs purchased in the in-store pharmacies.)
Advisory Opinion 12-13
(concerning a proposal by a hearing aid supplier to begin billing Medicare for certain audiometric testing, while continuing to offer free hearing tests to prospective hearing aid customers.)
Advisory Opinion 12-12
(concerning a proposed bundle billing arrangement for basic life support advanced life support joint responses.)
Advisory Opinion 12-11
(concerning an ambulance supplier's proposal to routinely waive cost-sharing amounts for emergency medical services rendered on a part-time basis.)
Advisory Opinion 12-10
(concerning a proposal by a radiology group to offer free insurance pre-authorization services to physicians and patients.)
Advisory Opinion 12-09
(concerning reduced-rate arrangements for the provision of therapy services at state-operated veterans' homes.)
Advisory Opinion 12-08
(concerning a proposal for an independent diagnostic testing facility to hire a doctor to read and interpret test results when that doctor is closely related to the owners of the independent diagnostic testing facility and is employed by a company that also employs other potential referral sources.)
Advisory Opinion 12-07
(concerning an exclusive arrangement between a county and an emergency medical services company whereby the company provides emergency ambulance services to county residents.)
Advisory Opinion 12-06
(concerning two proposals by an anesthesia services provider to enter into contracts with physician-owned professional corporations or limited liability companies to provide anesthesia services.)
Advisory Opinion 12-05
(concerning a rewards program under which consumers would earn gasoline discounts based on the amount spent on purchases in retail stores and pharmacies, including cost-sharing amounts paid in connection with items covered by Federal health care programs.)
Advisory Opinion 12-04
(concerning certain aspects of an exclusive contract for emergency transport services between a municipality and an ambulance company that reimburses the municipality for dispatch services and for certain costs incurred when municipal firefighters drive transports.)
Advisory Opinion 12-03
(concerning a proposal by a municipal fire department to share certain costs related to dispatch and other services with hospital-based ambulance providers that participate in the local 911 emergency dispatch system.)
Notice of Modification to Modified Advisory Opinion 08-17
(concerning Advisory Opinion No. 08-17, which was issued on 10-21-2008, as previously modified, regarding a nonprofit, tax-exempt, charitable organization's proposed arrangement to provide counseling from a law firm regarding financially needy patients' eligibility for federal and state funded benefits programs and, for patients who appear to be eligible, assistance from the law firm in applying for benefits.)
Advisory Opinion 12-02
(concerning a proposal to operate a website that would display coupons and advertising from health care providers, suppliers, and other entities.)
Advisory Opinion 12-01
(concerning a proposal to establish a group purchasing organization ("GPO") that would be wholly owned by an entity that also wholly owns many of the potential participants in the GPO, and to pass through to participants in the GPO a portion of the payments received by the GPO from vendors.)


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