OIG: No conflict in private billing arrangement

In its first advisory opinion of the year, the Department of Health and Human Services’ Office of Inspector General (OIG) has determined that a consulting firm’s potential arrangements for auditing services associated with private payers do not constitute grounds for sanctions under the anti-kickback statute because the arrangement does not involve federal health care program business. In addition, the principal activity under the arrangement is a one-time retrospective billing audit, the OIG found.

But Dan Mulholland, a partner with Horty, Springer & Mattern in Pittsburgh, warns that the opinion was looking only at a potential violation under the anti-kickback statute and not exposure under the False Claims Act because advisory opinions are limited to the question asked by the provider.