The OIG is sending letters to a large number of teaching hospitals requesting information on whether the hospital had written agreements in place for rotations to nonprovider settings for academic year 2004, purportedly pursuant to a requirement in the Medicare Prescription Drug, Improvement and Modernization Act ("MMA"). Hospitals probably have a duty to respond under a regulatory requirement for such written agreements; and any response must be accurate. There may be instances, however, where a written agreement can be construed to exist from other documents or where no agreement should be required because the nonprovider site is a part of the same legal entity as the hospital. The OIG request is directed to hospitals' GME offices for a response within 15 days. In order to avoid the submission of incomplete or incorrect information that may cause a hospital problems unnecessarily, the GME office should consult with finance and reimbursement personnel and legal counsel prior to responding to the request. We strongly suggest that each teaching hospital take the initiative to determine if this OIG request has been sent to the hospital, and if so, to be sure that it is completed accurately. For example, one potential area for confusion is that GME offices may identify off-campus, provider-based sites as nonprovider sites and report that there are no agreements in place with such sites.
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