Practice Advisory - Phlebotomists
04.02 Proper Utilization of In-office Phlebotomists
It is a common business practice for physicians to allocate space in their offices to a phlebotomist who is employed by a clinical laboratory for the purpose of collecting and transmitting samples of bodily fluids, etc. for lab testing purposes. While having the services of a phlebotomist in the physician’s office is a cost effective way of securing lab samples, increasing the accessibility of medical testing and greatly increasing the chances that patients will comply with the physician’s order, there are some risks of which you should be aware.
The American Clinical Laboratory Association (ACLA) has expressed concern that the placement of a phlebotomist in the physician’s office creates an opportunity in which the federal anti-kickback statute can be violated in the event the phlebotomist performs “additional” tasks that are normally the responsibility of the physician’s office staff. The ACLA introduced legislation in the Georgia legislature (SB 145) that would prohibit independent clinical laboratories from placing lab employees or contractors in physicians’ offices. MAG opposed this legislation but has agreed to issue a “Practice Advisory” to our members bringing this issue to their attention.
The federal anti-kickback statute prohibits the knowing and willful solicitation or receipt of any remuneration (free assistance with office tasks) in return for referring an individual or for recommending or arranging for services paid for by Medicare or any health care program. Thus, any remuneration that is received in return for recommending or arranging for lab services may violate the statute. For example, a phlebotomist who escorts patients to an examination room, performs routine office filing, or distributes office supplies may constitute such prohibited “additional” tasks.
While the placement in a physician’s office of a phlebotomist whose salary is paid for by a clinical laboratory does not constitute a violation of the federal anti-kickback statute, the statute may be implicated if the phlebotomist performs “additional” tasks that are normally the responsibility of the physician’s office staff. In order to insure that you do not unintentionally violate the anti-kickback law, we encourage you to clearly articulate to your staff as well as the assigned phlebotomist that the phlebotomist should not engage in activities outside the scope of their work as a phlebotomist in your office.
We hope that this information is helpful to you and encourage you to contact MAG’s Office of the General Counsel if you have any questions.