OIG ruling puts common fee arrangement in question. PPMCs: not dead yet, but facing major changes.

Abstract

A recent opinion by the Office of Inspector General has found that physician groups that pay management companies a percentage of revenue for marketing and network development may be in violation of federal anti-kickback statutes. Although it affects only the practice that sought the opinion, this decision could spark major changes in the way PPMCs and practices structure fee arrangements. In the future, more emphasis will have to be put on safeguards against abusive billing practices and over-utilization. The future of PPMC arrangement may be fixed fee agreements, but these, too, will have to be customized to each particular practice-PPMC relationship.