You know you’re a criminal if… New guidance on educational events at… strip clubs?

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Never in my 22 years of practicing health law have I encountered government-issued guidance involving strippers, until now.

More precisely, the Office of Inspector General of the Department of Health and Human Services (the OIG, otherwise known as the kickback police) referred to establishments where scantily-clad or non-clad women (e’hem) dance as “adult entertainment facilities” – but that was not really the point of its latest Special Fraud Alert.

In its Alert, the OIG lets us know that talks given by physicians at places like strip clubs that are sponsored by pharmaceutical and medical device companies could lack educational value and therefore violate the federal statute that makes it a crime to accept kickbacks from companies in exchange for you writing prescriptions for their drugs and devices.

There was more to it than just the strip clubs. Fishing trips, wineries, sports stadiums, and golf clubs are unacceptable also. Ladies, health spas did not make the list, but one might assume the educational nature of talks there may too be suspect. These locations, the Alert states, are troublesome if they are “not conducive to the exchange of educational information.”

The presence of alcohol also makes such “speaking programs” suspect. The Alert cited one talk where each attendee racked up $500 in food and alcohol charges. “The concern is heightened when the alcohol is free,” explains the Alert.

The federal Anti-Kickback Statute prohibits remuneration in exchange for referrals. The real point of this Alert is to undress, if you will, the term remuneration. It includes, according to the Alert, getting paid thousands of dollars to give talks for pharma and device companies. The Alert reads almost like the “you know you’re a redneck if…” jokes from Jeff Foxworthy. Let me channel my inner Jeff Foxworthy as I tell you more about the Alert:

If at a pharma or device company talk, you know you’re a criminal if:

• Strippers, fly fisherman, free booze, professional sports players or mulligans are in the room, stadium, course or stream.

• You were chosen to be the speaker after the drug company’s marketing department let you know you were their top prescribing physician of their drug or device.

• The marketing department is so kind that it creates the PowerPoint presentation for you to give.

• You are told you can be a speaker (translation: receive honorarium) if you write a certain number of prescriptions each month. #goals (In other words, if it reads like a credit card airline rewards promotion, only you are spending your patients’ money rather than yours, beware).

• You are asked to attend many of these sorts of events.

• You are at a “high-end restaurant where expensive meals and alcohol” are served. (No dollar signs like on Yelp were offered in the Alert, though, to provide guidance on the meaning of “high end” or “expensive.”).

• The sourdough crackers accompanying your Dom Perignon are fresh but the speaker’s content is stale (there’s been a significant period of time with no new scientific development or FDA-approval).

• Your spouse, mother, Cousin Bubba and kids are in the audience (i.e. “attendees include individuals who don’t have a legitimate business reason to be there” (friends, significant others or family members of the speaker)).

In all seriousness, folks, this kind of stuff stinks. Physicians, your reputations are worth more than the filet mignon and free fly fishing instructor. Maybe you won’t be indicted for a federal crime for listening to a talk about a drug before a NBA game that you attend for free. Maybe you will. But you don’t want to become a footnote in an OIG’s advisory opinion. We live in a time in which many Americans distrust physicians and science. Don’t add to that by attending a dressed up educational event that’s really nothing more than a bribe.