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GOVERNMENT & MEDICINELiability premium subsidies: Act with careBecause there is no clear OIG directive, physicians are encouraged to seek legal help before making any arrangements for a hospital to cover these costs.By Tanya Albert, AMNews staff. Feb. 10, 2003. The government hasn't given physicians struggling to pay for medical liability insurance the green light to enter into arrangements in which hospitals pay their premiums. But it hasn't given doctors the red light, either. Instead, the Dept. of Health and Human Services Office of Inspector General is telling physicians and hospitals to proceed with caution. With physicians in some states finding liability insurance increasingly difficult to afford, some hospitals have discussed the idea of helping to pay premiums so that they won't be left without doctors on their medical staffs. But if physicians and hospitals are thinking about such an arrangement, they have to consider whether it would violate anti-kickback statutes or the physician self-referral laws commonly known as Stark II. The medical liability crisis prompted a hospital group to ask the OIG about the legality of paying doctors' premiums. The chain has physicians on medical staffs in four states hit hard by rising medical liability insurance premiums -- West Virginia, Nevada, Florida and Texas. The hospital group's name was not disclosed in OIG materials. In a Jan. 15 response letter, OIG Chief Counsel Lewis Morris said the office historically had been concerned that "malpractice premium subsidies paid to, or on behalf of, potential referral sources, including hospital medical staff, may be suspect under the anti-kickback statutes." But the letter also noted that the OIG had made exceptions in the past, including a safe harbor for medical liability premium subsidies to physicians providing obstetrical care in primary care shortages areas. And depending on the circumstances, premium subsidies could fall under the employee- or physician-recruitment safe harbors, Morris wrote. [...]Full text of AMNews content is available to AMA members and paid subscribers.
Copyright 2003 American Medical Association. All rights reserved.
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