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Browse Advisory Opinions

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Showing 381–400 of 448 advisory opinions
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  • AO 01-18

    Concerning an exclusive contract for emergency ambulance services between County A, State B and Medical Center C under which County A has assumed the obligation to pay otherwise uncollected coinsurance amounts on behalf of County A residents. Specifically, whether such an arrangement would constitute grounds for the imposition of sanctions under the exclusion authority at section 1128(b)(7) of the Social Security Act (the "Act") or the civil monetary penalty provision at section 1128A(a)(7) of the Act, as those sections relate to the commission of acts described in section 1128B(b) of the Act, or under the civil monetary penalties provision for illegal remuneration tobeneficiaries at section 1128A(a)(5) of the Act.

    Posted November 7, 2001
  • AO 01-17

    Concerning whether an existing ambulatory surgical center ("ASC") joint venture between a hospital-affiliated entity and an entity owned indirectly by five ophthalmologists, together with the execution of three related ancillary agreements (the "Arrangement"), constitutes grounds for the imposition of sanctions under the exclusion authority at section 1128(b)(7) of the Social Security Act (the "Act") or the civil monetary penalty provision at section 1128A(a)(7) of the Act, as those sections relate to the commission of acts described in section 1128B(b) of the Act).

    Posted October 17, 2001
  • AO 01-16

    Concerning a managed care organization's employment of an excluded individual and potential sanctions under section 1320a-7a(a)(6) of the SSA.

    Posted October 5, 2001
  • AO 01-15

    Concerning a managed care organization's proposal to subsidize the Medicare+Choice premiums andcopayments of its members eligible for both Medicare and certain limited Medicaid benefits.

    Posted September 27, 2001
  • AO 01-14

    Concerning a hospital's policy of waiving out-of-pocket copayments and deductibles for screening services and certain follow-up services that the hospital offers to promote early detection of breast and gynecological cancers.

    Posted September 4, 2001
  • AO 98-05

    Regarding the "coordination of benefits" provisions of a provider agreement between a nursing home and a health care plan.

    Updated August 24, 2001
  • AO 01-13

    Concerning the "coordination of benefits" provisions of a provider agreement between ... a health maintenance organization or "HMO", and the skilled nursing facilities in its provider network (the "Nursing Facilities".)

    Posted August 24, 2001
  • AO 01-09

    Concerning a proposed grant from a hospital to a community health center to defray the costs of providing services to uninsured patients.

    Posted July 26, 2001
  • AO 01-10

    Concerning a political subdivision of a State that owns and operates an ambulance service and that treats the operating revenues received from local taxes as payment of otherwise applicable copayments and deductibles due from the residents.

    Posted July 26, 2001
  • AO 01-11

    Concerning a municipal corporation that owns and operates an ambulance service and that treats the operating revenues received from local taxes as payment of otherwise applicable copayments and deductibles due from the residents.

    Posted July 26, 2001
  • AO 01-12

    Concerning an exclusive contract between a city and an ambulance company for the provision of emergency medical services for city residents that includes a requirement that the contracting ambulance company waive out-of pocket Medicare copayments for city residents.

    Posted July 26, 2001
  • AO 01-08

    Concerns a comprehensive program that a manufacturer of therapeutic mattresses and other support services markets and sells to State-licensed nursing facilities to manage pressure ulcers.

    Posted July 10, 2001
  • AO 01-07

    Concerning the practice of accepting reimbursement from third-party payors plus certain payments.

    Posted July 3, 2001
  • AO 01-06

    Concerning "payments by vendors to a group purchasing organization (GPO) owned by entities affiliated with health care providers that purchase items covered by the GPO's vendor contracts."

    Posted May 29, 2001
  • AO 01-05

    Concerning "a proposed lease of cardiac diagnostic equipment to emergency medical services providers for a nominal charge."

    Posted May 23, 2001
  • AO 01-03

    Concerning "whether proposed contracts for discounted services between a Federally-recognized Indian tribe and local hospitals would constitute grounds for the imposition of exclusions under section 1128(b)(7) of the Act or civil money penalties under section 1128A(a)(7) of the Act."

    Posted May 10, 2001
  • AO 01-04

    Concerning "a proposed arrangement between a hospital and a new physician whom the hospital would like to recruit to practice within its service area."

    Posted May 10, 2001
  • AO 01-02

    Concerning an annual charity golf tournament for which some of its vendors and suppliers pay money as sponsors and tournament participants.

    Posted March 27, 2001
  • AO 01-01

    Concerning a proposed arrangement in which a hospital will share with a group of cardiac surgeons a percentage of the hospital's cost savings.

    Posted January 18, 2001
  • AO 00-10

    Regarding a program designed by a drug manufacturer to promote an expensive new drug used to prevent certain respiratory infections in pediatric patients.

    Posted December 28, 2000