As physicians have become more interested in receiving the full economic value of the work they produce, and they have sought increased control over their work environment, more and more often they have created and financed health care enterprises which may compete with the hospitals at which they have traditionally maintained medical staff privileges. Some hospitals have reacted with restrictive medical staff policies, intrusive inquiries into staff members’ financial relationships with other health care enterprises, controls over who may be a medical staff officer and a variety of other defensive behaviors. Some restrictions or threshold criteria for privileges reflect a real effort to safeguard quality in the hospital and are quite legitimate. Others really implicate the federal anti-kickback statute. The OIG has called for comments on how economic credentialing by hospitals may violate the anti-kickback statute. We are making available our comments to the OIG on these points.