To access the opinion, go to: http://www.dhhs.gov/progorg/oig/advopn/2001/index.htm

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This Advisory Opinion was requested by a regional hospital that proposes to assist the 4 local EMS providers in the purchase of new Life Paks. The providers will purchase half of the needed Life Paks and the Hospital, through its Foundation, will purchase the other half and then lease them to the providers for $1.00 per year.

The leasing of equipment at below market rates by a hospital to a provider that has the potential to refer patients to the hospital could be viewed as a violation of the anti-kickback statute if the purpose is to induce referrals of Medicare patients.

The key findings are as follows: "In the present case, the Proposed Arrangement presents a minimal risk of Federal health care program abuse, while providing significant benefits to the community. First, because it relates to emergency medical services only, the Proposed Arrangement presents little risk of overutilization or increased costs to any Federal health care program......

"Second, the Proposed Arrangement should not result in the steering of patients to Hospital A. The referral pattern between the EMS providers and the hospitals in the, including Hospital A, is preexisting and governed by extensive State and local regulatory protocols and procedures......

"Third, the Proposed Arrangement is consistent with a local EMS system that seeks to regulate, improve, and safeguard the provision of EMS in the GXA......

"Fourth, the Proposed Arrangement is likely to have a positive impact on the quality of patient care. This Advisory Opinion only applies to the specific case, but it gives other providers in similar situation an indication of how a similar arrangement would be viewed......."

The Advisory Opinion has more justification for each of these points which is very illustrative and should be read.

Caution: OIG Advisory Opinions only apply to the requesting agency. They cannot be relied upon by other entities for similar arrangements. They do however, illustrate how the OIG evaluates relationships and agreements that could be considered as violations of the anti-kickback statute.