On-Call Coverage Payments to Physicians: In the Spotlight

Published by Compliance Today

Adequate on-call emergency coverage is a real issue for hospital emergency departments and inpatients who require urgent specialist consultation. Sullivan Cotter and Associates’ 2008 Physician On-Call Pay Survey Report1 states that 85% of survey respondents have experienced difficulty finding physicians to provide on-call coverage. The problem has been severe enough, in some instances, that 16% of respondents reported the discontinuation of service lines due to lack of on-call coverage. Sullivan Cotter’s survey provides several statistics which support the trend in providing payments for on-call coverage:

• 86% of the survey respondents reported they currently provide compensation to non-employed physicians for call coverage.
• 70% of the respondents stated they provide additional pay for on-call services, or consider on-call duties in determining total compensation for employed physicians.
• Nearly two-thirds of those surveyed reported their on-call pay expenditures have increased in the past 12 months, with 15% of these respondents reporting increases of more than 50%.
• 28% of the respondents indicate they plan on implementing on-call pay within the next 6 months for physicians not currently receiving pay.

With physician compensation activity such as this, it is no surprise the Office of Inspector General (OIG) has brought on-call coverage payments to the spotlight by issuing its first advisory opinion related to on-call coverage last Fall. The following discusses the reasons for the growth of on-call coverage payments, compensation options, and what organizations should consider when determining if their arrangement meets the Fair Market Value (FMV) requirements.

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