OIG Advisory Opinion Finds “Insurance Only” Billing by Part-Time Ambulance Supplier May Violate Anti-Kickback Statute

The Office of the Inspector General of the U.S. Department of Health and Human Services (OIG) recently published OIG Advisory Opinion No. 12-11 (issued on September 4, 2012; posted on September 11, 2012) in response to a request concerning a proposed arrangement in which a supplier of basic life support (BLS) ambulance services (the BLS Supplier) would routinely waive cost-sharing amounts for emergency medical services (EMS) provided on a part-time basis. According to the OIG, such “insurance only” billing could potentially generate prohibited remuneration under the federal anti-kickback statute and lead to the imposition of administrative sanctions, subject to the requisite finding of intent.

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