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Legal Updates

Whose Turn To Pay? New OIG Opinion Provides Clarity Regarding Payment of Radiology Transcription Fees

01.18.2016

A new OIG opinion clarifies that providers are free to determine who will pay the transcription fees when separate parties perform the professional and technical components of a radiology exam.

Specifically, in Opinion 15-15, the OIG considered a proposal whereby a hospital bills a radiology group for transcription of the radiology group's reports for individuals who are not hospital patients, but rather patients of a third-party clinic that provides the technical component of the radiology exam. Under this proposal, the clinic would transmit the images performed on its patients to the radiology group for interpretation. The radiology group would then interpret the image, dictate a report, and send the dictated report to the hospital for transcription. The hospital would then transcribe the report and bill the radiology group a fixed per line transcription fee. The radiology group would bill for the professional component of the exam and the clinic would bill for the technical component.  

The parties requested that the OIG confirm whether the radiology group's payment of the transcription fees would constitute prohibited remuneration to the clinic in violation of the federal anti-kickback statute ("AKS").  In determining that this arrangement would not violate the AKS, the OIG relied on guidance from CMS which provides that when the technical and professional components of a radiology exam are performed by separate parties, the parties may determine who will pay the transcription fee. This is because the transcription fees are considered "indirect expenses" of the final written report and thus are not separately identifiable from the technical and professional component of the overall radiology service.

Therefore, even though the clinic is a referral source to the radiology group, the agreement by the parties that the radiology group pay the entire transcription fee is permitted under CMS payment rules and thus would not constitute prohibited remuneration to the clinic under the AKS.

If you have any questions about how this opinion might impact you or your business, please contact a member of Chambliss's Health Care Section.