On Dec. 14, 2022, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) issued Advisory Opinion No. 22-20 that addresses a request from an acute-care hospital, that provides a range of inpatient and outpatient hospital-based services. The hospital sought to determine whether its arrangement to utilize hospital's nurse practitioners (NPs) in providing Medicare and Medicaid beneficiaries with services that were previously only performed by participating physicians in certain units within one of the hospital's two campuses (the arrangement) may trigger the imposition of sanctions for potential violations under the federal anti-kickback statute (AKS) or the civil monetary penalties law (CMP) of the Social Security Act (the act).

Based on the facts submitted by the inquiring hospital the OIG concluded that the proposed arrangement would not be in violation of the AKS or the CMP and would fall under the safe harbor provisions of the act. The opinion stipulates that it is limited in scope and application and may not be relied upon by other persons. Nevertheless, it may have a significant favorable impact on the health care industry, especially for many underserved areas of the country with considerable deficiency in numbers of doctors, as the opinion may serve as a guide for hospitals to expand their services under certain circumstances and provide more comprehensive care to beneficiaries of federal health care programs, such as Medicare and Medicaid. The advisory opinion can be accessed on the OIG's website at www.oig.hhs.gov in the advisory opinion page of the compliance section.