Medicare Compliance & Reimbursement

Hospitals puzzled over what kinds of freebies they can provide their patients without running afoul of the anti-kickback statute could get some much-needed guidance if the HHS Office of Inspector General heeds the recommendations of a major hospital group.

In Feb. 6 correspondence with IG Janet Rehnquist, the Federation of American Hospitals weighed in on possible new safe harbors to the antikickback statute and helpful clarifications to the governing regulations. In addition to throwing its support behind safe harbors the OIG is already contemplating — for clinical trials, for transportation and for inducements of low value — the FAH also suggested the OIG should:

• make it clear that the provision of free car seats to new mothers isn’t a kickback violation;

• develop a safe harbor for limited medical screenings — such as blood pressure tests — that, while not technically covered by the preventive care exception, are beneficial to patients and unlikely to influence their choice of provider; and

• create an exception for medically necessary drugs that aren’t covered by Medicare, particularly drugs provided to hospital outpatients that aren’t related to the patients’ diagnosis but must be taken to treat a pre-existing condition.

Lesson Learned: Medicare anti-kickback rules are riddled with gray areas that need constant and vigilant attention from compliance officers.