Medicare, Medicaid patients get limited free hospital services

Q&A with Elizabeth Dalton

published in The Oklahoman | March 24, 2016

Business and healthcare attorney Elizabeth Dalton was interviewed by The Oklahoman about a recent opinion issued by the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services stating that an academic medical center’s offer of free transportation and lodging to certain patients did not violate the Federal Anti-Kickback Statute. Many of the pregnant patients who were offered these complimentary services qualified for state or federal health care aid.

“The federal Anti-Kickback Statute makes it a criminal offense to knowingly and willfully offer, pay, solicit or receive any remuneration to induce or reward referrals of items or services reimbursable by a federal health care program, such as Medicare and Medicaid,” said Dalton. “A health care provider may even be excluded from participation in the Medicare and Medicaid programs for violating these rules, which could put it out of business.”

The opinion was significant in that the OIG has previously taken the position that only incentives that are “nominal in value,” meaning no more than $10 per item or $50 in the aggregate on an annual basis, were permitted, she said.

“The OIG’s opinion further reflects a certain tolerance for aid that is clearly designed to promote continuity of care under exigent circumstances, where the risk that the aid will influence the selection of a provider by a federal health care program beneficiary is limited,” said Dalton.