In OIG Advisory Opinion No. 10-24, a sleep testing entity with no physician ownership proposes to provide sleep disorder diagnostic testing and related services to a hospital as “under arrangements” contract, in which the hospital would bill for the services as a hospital outpatient service. The Requester would provide the sleep testing equipment, the sleep testing staff and supplies, excluding the interpreting physician, and marketing services. The contract provides for three annual fixed fee components for the equipment, the services and supplies, and the marketing.

The OIG concluded even though the arrangement involved marketing by the sleep testing service, the fixed fee aspects of the three different components mitigated any chance for remuneration in exchange for the volume or value of referrals and concluded that the arrangement did not present an unacceptably high risk of generating prohibited remuneration and the OIG would not impose administrative sanctions.