The U.S. Department of Health and Human Services Office of Inspector General (OIG) has issued a robust advisory opinion scrutinizing arrangements between physician practices and telehealth platforms, alongside recent corporate practices in the telehealth sector. In Advisory Opinion 25-03 released on June 11, 2025, the OIG addressed a proposed model where a management support organization and physician-owned entity would lease clinical staff and secure administrative services—such as payer contracting—from third-party telehealth platforms to facilitate remote care delivery.
The opinion highlights concerns over potential kickback violations under the Anti-Kickback Statute (AKS), particularly as telehealth companies often face limited in-network payer contracts, risking reduced patient access and higher out-of-pocket costs. The OIG approved the arrangement, deeming it safeguarded by AKS safe harbors due to structured safeguards: fees are tied to fair market value, services are bona fide (e.g., billing, credentialing), and referrals occur only when both parties share payer contracts. This allows practices to expand in-network telehealth access for underserved populations, especially in rural areas.
Notably, the opinion sets a precedent for telehealth partnerships, clarifying that administrative service agreements may avoid AKS violations if designed to enhance care accessibility rather than induce referrals. It also signals the OIG’s focus on corporate practices in telehealth, emphasizing transparency in fee structures and preventing financial arrangements that could compromise medical objectivity.
“This opinion provides critical clarity for telehealth growth while reinforcing ethical boundaries,” said an OIG official. The ruling comes as telehealth use has surged, with concerns mounting over profit-driven referrals and unequal access. By legitimizing structured collaborations, the OIG aims to balance innovation with regulatory compliance, ensuring telehealth services remain patient-centered and financially equitable.
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