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Telehealth Done Right
Manage episode 500983645 series 3506216
The Office of Inspector General (OIG) recently issued an advisory opinion approving a telehealth business model where a management company leases clinicians and provides backend services—like scheduling, billing, and digital marketing—to a separate physician practice. While this setup might raise anti-kickback concerns, OIG says it’s compliant under the personal services and management contracts safe harbor.
This matters for pharma, digital therapeutics, and connected device companies increasingly partnering with telehealth platforms. The opinion clarifies that digital marketing services promoting physician practices can be paid for—if structured correctly. Key compliance factors include fair market value, written agreements, and fixed fees not tied to patient volume.
But beware: this opinion doesn’t bind the DOJ, doesn’t address state law or Stark, and hinges on a narrow fact pattern. If your telehealth strategy involves clinician leasing or third-party reimbursement, now’s the time to review your management services agreement.
Bottom line: this is both a roadmap and a red flag. Get the structure right—or risk regulatory trouble.
262 episodes
Manage episode 500983645 series 3506216
The Office of Inspector General (OIG) recently issued an advisory opinion approving a telehealth business model where a management company leases clinicians and provides backend services—like scheduling, billing, and digital marketing—to a separate physician practice. While this setup might raise anti-kickback concerns, OIG says it’s compliant under the personal services and management contracts safe harbor.
This matters for pharma, digital therapeutics, and connected device companies increasingly partnering with telehealth platforms. The opinion clarifies that digital marketing services promoting physician practices can be paid for—if structured correctly. Key compliance factors include fair market value, written agreements, and fixed fees not tied to patient volume.
But beware: this opinion doesn’t bind the DOJ, doesn’t address state law or Stark, and hinges on a narrow fact pattern. If your telehealth strategy involves clinician leasing or third-party reimbursement, now’s the time to review your management services agreement.
Bottom line: this is both a roadmap and a red flag. Get the structure right—or risk regulatory trouble.
262 episodes
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