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It is legal as long as the adjustment is done based on a determination that the patient is unable to pay due to financial hardship.

The OIG's position on waiver of patient share states that "providers … may forgive a Medicare coinsurance or deductible amount in consideration of that patient’s financial hardship … so long as: (1) the waiver is not offered as part of any advertisement or solicitation; (2) the party does not routinely waive the cost sharing obligations; and (3) the party waives the coinsurance and deductible amounts after determining in good faith that the individual is in financial need or reasonable collection efforts have failed."
 
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