Hospitals should evaluate EKG arrangements for compliance with anti-kickback statute.
The discontinuation of separate payments for EKG interpretations, and the manner in which HCFA has bundled reimbursement for this service with all visits and consultations, has generated significant controversy because of its often illogical impact. For example, the new method results in additional reimbursement to certain specialists who rarely, if ever, order EKGs (e.g., dermatologists), while cardiologists and other internists who routinely interpret EKGs ordered by others receive no direct Medicare reimbursement. Consequently, several bills have been introduced in Congress that would repeal this provision. While there is a reasonable possibility that one of these bills will eventually be enacted, as of this writing the ban on separate interpretation payments remains in effect, and hospitals must therefore remain cognizant of the fraud and abuse implications of their payment arrangements with physicians who interpret EKGs.
Scarano
R M
RM
D003415:Crime / Q000331:legislation & jurisprudence; D004562:Electrocardiography / Q000191:economics*; D005607:Fraud / Q000331:legislation & jurisprudence*; D006788:Hospitals, Voluntary / Q000331:legislation & jurisprudence; D016365:Liability, Legal; D008505:Medical Staff, Hospital / Q000191:economics / Q000331:legislation & jurisprudence*; D006278:Medicare / Q000331:legislation & jurisprudence; D012017:Referral and Consultation / Q000191:economics* / Q000331:legislation & jurisprudence; D014481:United States