Unnamed radiology group gains federal OK to subsidize Medicare costs in upcoming PET study

An unnamed radiology society has been given the green light to subsidize certain Medicare coinsurance costs in an upcoming study investigating brain amyloid and Alzheimer’s disease, federal officials said Monday.

The Office of the Inspector General outlined its decision in an advisory opinion published Oct. 4. Despite the proposal violating parts of the federal anti-kickback statute, the OIG said it would not enact sanctions.

Under the nine-page arrangement, a “professional society representing radiologists” would pay outpatient imaging facilities directly for the coinsurance that a Medicare beneficiary would otherwise owe for amyloid PET scans. A nonprofit supporting Alzheimer’s research is also involved in the study.

The OIG redacted the names of these organizations, but Thomas W. Greeson, a partner at law firm Reed Smith LLP, believes the groups are the American College of Radiology and Alzheimer’s Association, he explained in a recent viewpoint article.

ACR did not immediately offer comment on Thursday and the Alzheimer’s Association did not respond to a Health Imaging email request.

The unnamed radiology group leading the study plans to enroll about 350 hospital outpatient departments or independent testing facilities to perform amyloid PET scans, according to the opinion. Researchers will assess whether such imaging affects outcomes in patients with mild cognitive impairment, focusing particularly on underrepresented minority groups.

The anonymous pair said the cost-sharing arrangement removes a key financial barrier for minority patients, allowing a more diverse study population.

“The OIG will not proceed against [unnamed] requestors with respect to any action that is part of the proposed arrangement taken in good faith reliance upon this advisory opinion, as long as all of the material facts have been fully, completely, and accurately presented, and the proposed arrangement in practice comports with the information provided,” according to the OIG opinion.

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Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.

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