“The Office of Inspector General was established at the Department of Health and Human Services by Congress in 1976 to identify and eliminate fraud, abuse and waste in Health and Human Services programs and to promote efficiency and economy in departmental operations. The OIG carries out this mission through a nationwide program of audits, investigations and inspections. To help reduce fraud in the Medicare and Medicaid programs, the OIG is actively investigating violations of the Medicare and Medicaid anti-kickback statute, 42 U.S.C. Section 1320a-7b(b).”
On November 16, 2020, the Office of Inspector General (OIG) issued a Special Fraud Alert that speaker fees and programs are often used to reward high-prescribing doctors in violation of the anti-kickback statutes. Some of the features of offending speaker programs include:
- Selecting high-prescribing doctors to be speakers and paying high fees, sometimes hundreds of thousands of dollars;
- Conditioning speaker fees on meeting prescription targets;
- Holding programs at high-end restaurants with expensive meals and alcohol;
- Inviting attendees who have already attended;
- Inviting spouses and family members or a doctor’s staff members without a business reason to attend;
- Offering programs where little substantive information about the risk, benefits, and uses of the medicine is presented;
- Offering alcohol, especially free alcohol, with meals;
- Holding programs at restaurants, entertainment, or sports venues that are not suitable for educational programs;
- Holding a large number of speaker programs on the same product with no recent substantive change in relevant information;
- Paying speakers more than the fair market value of the speaking service based on present or potential prescription volume.
See the full Special Fraud Alert: Speaker Programs below.