Some Physicians Elect Not To Accept Gifts From Industry

It is no secret that the federal government is very interested in the connection between gifts and other remuneration from drug and device manufacturers and physician decision-making when it comes to ordering those items.  At least one Senator has gone so far as to introduce legislation which would require disclosure of these financial relationships.  According to a recent article in the Baltimore Sun, some doctors are voluntarily refusing to accept gifts from industry. 

While the legal ramifications of accepting remuneration from industry for goods and services covered by federal payor programs are quite severe under the federal anti-kickback statute, the line between what will be tolerated (e.g., low cost meals coupled with an educational program) and what will land a physician in hot water has become blurred.  This confusion is likley due, at least in part, to the pharmaceutical and device industries' efforts to self-police through their own codes of conduct which permit conduct not expressly permitted under the anti-kickback statute. 

As the Baltimore Sun article illustrates, some doctors are beginning to recognize that even if a compensation arrangement with industry is permissible -- or at least tolerated -- under federal law, there may still be negative consequences to particpating.  In particular, the public may be left with the perception -- right or wrong -- that a doctor with industry ties has a conflict of interest.  The legal implications are no doubt important, but doctors should remember that how something will look on the front page of the newspaper may be just as important.

Meet the New Doc: Researchers Develop Computerized Anesthesiologist

Canadian researchers may have solved the looming physician shortage crisis -- at least as it would apply to the administration of  surgical anesthesia.  According to an article in the Canadian Press, scientists at McGill University in Montreal have developed a software system that administers anesthesia during surgery.  Not possible you say?  According to the article, the system has been successfully tested and actually performed better than its human counterparts in some respects.  The researchers at McGill are quick to point out in the article that the machine will not replace human anesthesiologists but there are undoubtedly more than a few managed care and hospital executives rooting for this technology.

MCARE Abatement Program Still A Political Football

According to a recent article in the Patriot News, Governor Rendell has outlined the costs associated with his plan to provide health insurance for Pennsylvania's uninsured population.  The plan calls for increases in taxes on tobacco products and would tap into the MCARE fund to cover the health insurance costs.  However, according to Rendell, the plan would result in enough money to ultimately eliminate the MCARE premiums currently charged to physicians.  According to the article, Governor Rendell is seeking physician support of his plan, which, with minor modification, the Pennsylvania House of Representatives has already approved.  Rendell has already said that unless Pennsylvania legislators are able to work out a deal to expand the State’s uninsured health insurance program, he will not approve extension of the MCARE abatement program.  

Feds Challenge Physician/Hospital Cardiology Arrangement

The federal government was apparently not kidding when it said it planned to take a closer look at physician/hospital arrangements.  According to a recent Department of Justice Press Release, the DOJ has elected to intervene in a whistle-blower lawsuit against Christ Hospital and the Ohio Heart Health Center, a large cardiology group in Ohio. The lawsuit alleges that the hospital and the cardiology group entered into an arrangement that provided the cardiologists improper financial incentives in exchange for generating revenue for the hospital through the hospital’s outpatient cardiology testing center. This suit was originally filed by a cardiologist who had provided services to Christ Hospital and Ohio Heart. The lawsuit alleges that cardiologists were allocated time at the Hospital’s heart station based on the number of cardiac services they generated for the Hospital in the prior year.

This is only one of what can expected to be a slew of these types of cases as enforcement authorities tune in to the creative ways in which hospitals and physicians have been teaming up over the last few years.  Physicians who have financial arrangements with their hospitals should take a close look at those arrangements for compliance with current regulatory requirements.