It may be better to give than to receive, but keep costs low. You'd love to spread some holiday cheer to your patients -- just don't consider doing it with pricey gifts. The HHS Office of Inspector General specifically addresses gifts to Medicare and Medicaid beneficiaries in an August 2002 special advisory bulletin, points out attorney Matthew Biggers with Mitchell Day in Ridgeland, Miss. "Congress has broadly prohibited offering remuneration to Medicare and Medicaid beneficiaries," the OIG says in the bulletin. However, small gifts -- $10 per gift, up to $50 annually per patient -- are permissible, the watchdog agency allows. Pitfall: The OIG says cash or cash equivalents are not OK, however, Biggers notes. That means you'll need to cross gift cards off your list. It's easy to overlook patient gift-giving in your compliance efforts. "Hospices have long understood the potential of violating the anti-kickback provisions in providing something of value to a referral source," notes Madison, Wis. law firm Reinhart Boerner Van Deuren in a white paper about the bulletin. "However, offering valuable gifts directly to beneficiaries is also impermissible." Remember: Free services also count as gifts, the OIG says in the bulletin. Note: The OIG special bulletin is at http://oig.hhs.gov/fraud/docs/alertsandbulletins/SABGiftsandInducements.pdf.