PET registry warns providers against paying referring physicians for surveys

August 15, 2006

The National Oncologic PET Registry has warned PET providers that paying referring physicians to participate in its program may violate federal and state anti-kickback laws.

The National Oncologic PET Registry has warned PET providers that paying referring physicians to participate in its program may violate federal and state anti-kickback laws.

The registry issued the warning on its Web site July 14, several days after learning that one or more facilities were allegedly paying referring physicians to complete the patient surveys that are a core element of the registry research program, according to Dr. Barry Siegel, cochair of the program.

The NOPR referred the incidents to the Office of the Inspector General after a complaint from an unidentified source, who also contacted the Medicare Office of Program Integrity, Siegel said.

The NOPR was implemented in May as part of an agreement between the Centers for Medicare and Medicaid Services and radiology groups that has greatly expanded Medicare coverage of PET cancer imaging in exchange for research that will measure the impact of the new applications on patient management. The NOPR established an elaborate electronic reporting system enabling referring physicians to file questionnaires completed before and after PET imaging to determine how it influenced clinical decision making.

Medicare enforces compliance by denying payment when reporting deadlines are not met. A preprocedure survey must be filed no later than midnight on the day of imaging. A postprocedure survey must be filed within 30 days after a procedure.

In its July 14 statement, the NOPR expressed concern that paying referring physicians to complete the case report form could compromise the program's integrity and potentially run afoul of federal and state anti-kickback laws. The laws prohibit imaging services from paying physicians for patient referrals.

"The statutes apparently do provide for reasonable compensation for certain efforts that may be required for administrative tasks. The question is what constitutes reasonable. The numbers we saw exceed what we thought were reasonable for the amount of time and effort involved," Siegel said.

The NOPR advised participants to confer with their lawyers.

Since its inception, the NOPR has known that referring physician compliance with the program's reporting requirements could be a problem, but there is no evidence that participants are having trouble meeting the deadlines, Siegel said.

"From the beginning, we made it clear that the program will require some educational effort and some handholding with referring physicians," Siegel said. "We've faced lots of issues, but referring physicians refusing to do the forms is not one of them."

For more information from the Diagnostic Imaging archives:

Change in PET registry rules could trip up early registrants

Launch of registry aims to advance PET reimbursement

PET registry boosts coverage outlook for rare cancers

National Oncologic PET Registry takes initial enrollment steps