Eyeworld Daily News

EW SHOW DAILY 20 Monday, May 9, 2016 ASOA News Today by Lauren Lipuma EyeWorld Contributing Writer According to Mr. Reider, some compliance mistakes are dangerous in that they are common and can easily attract the attention of whis- tleblowers or government agencies. Committing 1 compliance mistake could have a domino effect in that it could open the door for the govern- ment to investigate an entire prac- tice's operations, rather than just 1 incident, he said. Relationships with optometrists Mr. Reider and Ms. Shuren discussed the legal and practical risks of cer- tain compliance mistakes, offered O phthalmology practices can make a myriad of mistakes when it comes to compliance, but some mistakes are downright dangerous, according to 2 health- care law experts who presented at a Sunday morning ASOA session. Alan Reider, JD, MPH, and Allison Shuren, JD, MSN, Washington, D.C., discussed common compliance mistakes ophthalmologists make concerning their relationships with optometrists, the Office of Inspector General (OIG) exclusion list, docu- mentation errors, and more. strategies for avoiding and dealing with them, and how the govern- ment is likely to respond. Ophthalmologists and optome- trists (ODs) can have different kinds of relationships—ODs can refer patients, lease equipment or office space to ophthalmologists, co-man- age patients, or even be equity partners in a practice or ambulatory surgery center (ASC). Ophthalmologists often provide education or perks to their referring ODs, and while this in itself is not a problem, ophthalmologists should be careful about how they do this, Mr. Reider said. The Anti-Kickback Statute prohibits ophthalmologists from providing anything of value to induce a referral from an OD, and there is no minimum dollar amount that is protected from the law, he said. Mr. Reider does not think the government would challenge physicians who provide education to ODs, but he would be concerned when something more than educa- tion is involved, such as the provi- sion of continuing education credits, an extravagant dinner, or if the education was provided in a resort during the weekend. If you're providing education to ODs, don't limit these opportunities to only referring ODs, he said, and keep it simple. "Make it clear that the pur- pose of this is not to provide a nice dinner in a nice place for your ODs," Mr. Reider said. "Make it clear that the purpose is the provision of edu- cation." In addition, never accept any sponsorship from industry for these events; there's no way to justify it, Mr. Reider said. A better idea would be to reach out to local OD societies and have the society do the sponsor- ing—this is a great way to avoid any potential problems, he said. Dealing with the OIG exclusion list Ophthalmology practices must be vigilant about ensuring their employees are not on the OIG exclusion list for healthcare work- ers, according to Ms. Shuren. Every time a practice has a new hire, a new contractor, or a new vendor, check- ing the list should be first thing you do, she said. In addition, continue to check the list at least once a year—this includes checking everyone in your practice or ASC and all major vendors. "Checking the list is not a 1-time obligation," Ms. Shuren said. Some states even require practices to check the list monthly. In these cases, it is easiest and fastest to have the same person check each time, she continued, but there are also automated programs that can do it for you. If you do find an employee is on the list, ignoring it is not an option, Ms. Shuren said. Voluntarily report- ing it should be the first thing you do. "The penalties are far greater if the OIG finds out from someone else," she said. If an employee does show up on the exclusion list, voluntarily report it and immediately prohibit that person from providing care to feder- ally insured patients while you work with the OIG to sort out the prob- lem and determine a settlement. Remember that it is always your responsibility to check the list. "Don't think that you're OK if you ask every employee to certify that they are not on the list," Ms. Shuren concluded. EW Avoid making these common compliance mistakes Mr. Reider offers strategies for avoiding compliance problems when it comes to ophthalmologists' relationships with optometrists. " Make it clear that the purpose of this is not to provide a nice dinner in a nice place for your ODs. Make it clear that the purpose is the provision of education. " –Alan Reider, JD, MPH

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