The OIG Has a Gift For You!

Dear friends,



The following article describes an increase in the limits on free items and
services given to beneficiaries. Feel free to share this information. If
you decide to use this material, please include our copyright designation
that is shown at the end of the article and send us a copy of any
publication in which the material appears.



Please do not hesitate to contact us with comments, questions, or requests
for additional information.



Elizabeth



Elizabeth E. Hogue, Esq.

Office: (877) 871-4062

Fax: (877) 871-9739

Twitter: @HogueHomecare


ElizabethHogue@ElizabethHogue.net





The OIG Has a Gift For You!



Well, sort of! The Office of Inspector General (OIG) of the U.S. Department
of Health and Human Services, the primary enforcer of fraud and abuse
prohibitions has announced that effective on December 7, 2016, the limits on
free items and services give to beneficiaries have been increased.
Specifically, according to the OIG, items and services of nominal value may
be given to patients or potential patients that have a retail value of no
more than $15 per item or $75 in the aggregate per patient on an annual
basis. The previous limits were $10 per item or $50 in the aggregate per
patient on an annual basis.



Under section 1128A(a)(5) of the Social Security Act, persons who offer or
transfer to Medicare and/or Medicaid beneficiaries any remuneration that
they know or should know is likely to influence beneficiaries' selection of
particular providers or suppliers of items or services payable by the
Medicare or Medicaid Programs may be liable for civil money penalties for up
to $10,000 for each wrongful act. "Remuneration" includes waivers of
copayments and deductibles, and transfers of items or services for free or
for other than fair market value.



In the Conference Committee report that accompanied the enactment of these
requirements, Congress expressed a clear intent to permit inexpensive gifts
of nominal value from providers and suppliers to beneficiaries. In 2000,
the OIG initially interpreted "inexpensive" or "nominal value" to mean a
retail value of no more than $10 per item or $50 in the aggregate per
patient an annual basis. The OIG also expressed a willingness to
periodically review these limits and adjust them based on inflation.



Consequently, effective on December 7, 2016, the OIG has increased the
limits of items and services of nominal value that may be given by providers
and suppliers to beneficiaries to a retail value of no more than $15 per
item or $75 in the aggregate per patient on an annual basis. Providers may
not, however, give cash or cash equivalents. The OIG also says that these
amounts may increase again in the future. So, just in time for the holiday
season, providers and suppliers may now give patients and potential patients
items or services worth $15 per item or $75 in the aggregate, as described
above.



In view of some patients' needs for basic items, such as food, these amounts
may still seem paltry to many providers and suppliers. According to the
OIG, providers who see that patients need items worth more than these limits
should establish relationships with charitable organizations that can
provide items and/or services that are not subject to these limits. In
other words, work together to meet the needs of patients!





C2016 Elizabeth E. Hogue, Esq. All rights reserved.



No portion of this material may be reproduced in any form without the
advance written permission of the author.
Sign In or Register to comment.