In light of the COVID-19 pandemic, the healthcare landscape is shifting toward increased preparedness for widespread viral events. Supplemental to the potential shortage of physicians and personal protective equipment (PPE), how are providers preparing for a projected outbreak?
One avenue that hospitals may pursue to address preparedness is forming a special physician committee to develop pandemic-related action plans. In establishing such committees, hospitals will need to determine who should be included on the committee and if/when to pay physicians for their participation. Ultimately, unless certain Stark Law waivers and their related documentation requirements are met, payments should adhere to fair market value (FMV) and commercial reasonableness (CR) standards to meet applicable regulations.
In PYA’s experience, some hospitals are compensating physicians for pandemic committee participation, while others are not. Of those that are, several reasons include, but are not limited to:
- Disruption to a physician’s normal office hours.
- Preparation and active participation to address an emergent community need.
- Accomplishment of a specific goal or deliverable, usually under a tight deadline.
- A physician’s service in committee leadership (e.g., Chairs and Vice Chairs).
While some hospitals may entirely depend on employed physicians and established medical directors to serve on these committees, many also include independent, private practice community physicians. One benefit of including both employed and designated community physicians, besides having more comprehensive medical staff involvement, is the myriad of perspectives each type brings to the table. This allows all affected to contribute to the conversation, rather than limiting input and perspective to only an organization’s employed physicians and/or medical directors.
Finally, to assist organizations considering the development of a physician pandemic committee, below is a non-exhaustive list of questions to ask in determining FMV and CR in these situations:
- Will the committee duties be thoroughly documented?
- Will evidence of committee efforts and project milestones be maintained?
- Should compensation be based on an internal compensation plan tied to a specific specialty? Conversely, should a standard administrative or medical director rate be used (i.e., not specialty-specific)?
- Is the committee anticipated to be short-term or long-term in duration?
- Should length of service on the committee be considered?
- Should participation on the committee be documented by the physicians and submitted to the organization in order to receive payment? If not, how will the organization substantiate the work performed by the physician on the committee in support of the compensation paid?
- Are the committee duties and related compensation already included as part of the physician’s compensation or paid to the physician during times allocated for a physician to practice clinically, essentially resulting in double payment for the same period of time or services provided?
- Is another committee or administrative leadership effort duplicating the work of the pandemic readiness committee, resulting in payment to two different physicians for the same work effort?
If you have questions related to physician compensation, pandemic physician committees, and/or the appropriate documentation of the provision of COVID-19-related physician services, or if you would like additional COVID-19 guidance, visit PYA’s COVID-19 hub, or contact one of our PYA executives below at (800) 270-9629.
