With the national call-to-action to crack down on healthcare fraud, an increasing number of healthcare providers are finding themselves under investigation for conflict of interest-related healthcare fraud.Often, implicated physicians merely didn’t follow proper disclosure protocols or didn’t fully understand all the rules. It can be quite difficult to ascertain exactly what business relationships are legal and/or ethical and which aren’t, particularly because a physician is expected to follow numerous overlapping disclosure rules from a number of sources, such as:

  • independent grant funders;
  • universities;
  • the National Institutes of Health; and
  • the Food and Drug Administration

Examples of Conflict of Interest in Healthcare

The Institute of Medicine defines a conflict of interest as “a set of circumstances that creates a risk that professional judgment or actions regarding a primary interest will be unduly influenced by a secondary interest.”

Some examples of activities that might lead to a healthcare fraud investigation related to a conflict of interest include:

  • contributing to a healthcare company’s purchasing decisions about products from companies in which you have a financial interest;
  • accepting gifts from vendors and pharmaceutical companies;
  • referring patients to any company, product or service with which you have some sort of financial interest; and
  • giving speeches, talks or seminars on behalf of a company.

Following Disclosure Requirements

Even if your relationship with the company in question is legal, you’ll still need to be certain that you follow any obligations you have to disclose the relationship. You’ll want to manage your conflict of interest carefully to avoid getting into hot water. Ask for assistance from a legal professional if you need help managing this.

Make sure you openly disclose any money you have or will receive that’s subject to conflict of interest policies, and strictly adhere to any restrictions these policies have on your professional activities.

The U.S. Department of Health and Human Services shares a good tip for determining whether or not a conflict of interest exists: “You always can apply the ‘newspaper test’ and ask yourself whether you would want the arrangement to appear on the front page of your local newspaper.” If you wouldn’t want it to appear, chances are, you should avoid it.

Staying Clear of Healthcare Fraud

The Institute of Medicine (US) Committee on Conflict of Interest in Medical Research shares several recommendations for physicians that will help ensure the lines between healthcare relationships are not blurred. Regarding conflict of interests, the committee recommends avoiding:

  • accepting gifts, money, food or anything of material value from pharmaceutical companies or medical supply companies;
  • making any presentations or authoring any articles that are controlled by the industry;
  • signing any contracts for consulting arrangements with companies until the contracts are absolutely legitimate and you are rendered expert services in which you’re compensated at a fair market value;
  • having any undocumented meetings with pharmaceutical and medical device sales representatives; and
  • accepting drug samples.
If Unsure of Your Responsibilities, Ask an Attorney

Cases of healthcare fraud often necessitate help from a legal professional. If you are under investigation for any type of healthcare fraud, including that related to conflict of interest, call the Law Offices of Robert David Malove in Fort Lauderdale for legal assistance. Contact our firm today to schedule a free, no-obligation case evaluation – (888) 744-8225.