The Department of Health and Human Services Office of Inspector General (OIG) has evaluated several proposed arrangements related to COVID-19 and identified safeguards that pose a low risk of fraud and abuse, says Jennifer E. Michael, JD, an attorney with Epstein Becker Green in Washington, DC.
Through several responses to proposed arrangements, OIG identified safeguards applicable to most situations that will make remuneration safe from enforcement under anti-kickback and civil monetary penalty rules, Michael says. She offers this summary:
- The arrangement is necessary because of COVID-19 and will exist only during the public health emergency.
- The remuneration is provided to a recipient who is financially needy.
- The remuneration consists of in-kind material or services required for the recipient to access medically necessary services.
- The healthcare organization does not advertise the remuneration and provides it only to established patients.
- A beneficiary’s eligibility for assistance is not determined through a method related to the volume or value of federal healthcare program business.
- The arrangement is documented in a written agreement.
- The healthcare provider offers the remuneration to eligible providers on an equal basis.
- There is no requirement for the person or entity receiving the remuneration to refer patients to a particular individual or entity. The arrangement does not restrict the receiving person or entity’s referrals.