The Curators of the University of Missouri on behalf of the University of Missouri Health Care and University Physicians (CUMHC) agreed to pay $100,000 for allegedly violating the Civil Monetary Penalties Law, including provisions applicable to kickbacks.
The settlement comes after they self-disclosed conduct to the United States Department of Health and Human Services Office of Inspector General (HHS OIG) and HHS OIG alleged that CUMHC provided remuneration to more than 100 community physicians in the form of free continuing medical education and meals.
HHS OIG has the ability to seek civil monetary penalties when individuals and/or entities engage in a wide variety of prohibited conduct. In this instance, CUMHC seems to have violated the Anti-Kickback Statute, which prohibits individuals and entities from asking for – or receiving – any remuneration in exchange for referrals of Federal health care program business (including Medicare, Medicaid, and TRICARE). When individuals or entities knowingly and willfully offer or pay remuneration to induce referrals of Federal health care program business or solicit or receive remuneration in return for referrals of Federal health care program business.
When a civil monetary penalties case is resolved through a settlement agreement, the settling party (in this case, CUMHC) has contested HHS OIG allegations and denied liability.
HHS OIG Advisory Opinion 22-14
We have previously written about HHS OIG Advisory Opinion No. 22-14, which was written in response to a proposed CME program for local optometrists conducted by an ophthalmology group practice. The Requestor offered four potential funding options for the programs and sought advice on whether any would violate the federal anti-kickback statute or any other laws.
Of the four proposed funding options, HHS OIG found that all four would “generate prohibited remuneration under the Federal anti-kickback statute if the requisite intent were present.” Three of the four would have also constituted “grounds for the imposition of sanctions under sections 1128A(a)(7) and 1128(b)(7) of the Act.”
It’s important to note that the advisory opinion is limited to the specific facts presented to HHS OIG. Guidance has long been provided by various agencies and organizations regarding sponsored educational activities, including the 2003 OIG Compliance Program Guidance for Pharmaceutical Manufacturers, the 1997 guidance from the United States Food and Drug Administration (FDA), and the ACCME Standards for Integrity and Independence.