Are You Discounting Services or Giving Gifts?
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Before presenting gifts or inducements to your patients, several factors require careful consideration. In this week’s video, we delve into the Federal regulations regarding gifts and inducements. Tune in to gain more knowledge!
Link for today’s video:
Articles pertaining to gifts and inducements
So you’re looking to do a new offering. In your practice, you want to do a new coupon or you’ve got a new gift that you want to give your patients or you run, or you want to run a promotion. There are a lot of factors that have to be to be looked at in this. In fact, you want to go out and take a look at our discount articles, you want to look at our gifts articles, you want to look at all of the information we have online. But the one we’re going to talk about today really centered around the federal aspect of gifts and inducements.
There are two key statutes that really govern gifts and inducements. And that is the anti-Kickback Statute and the Civil Monetary Penalties Law. Both of those really hone in. And by the way, there are also other state fraud, waste, and abuse laws that kick into play here. But those are really the two that we’re going to talk about. That is where OIG or the Office of Inspector General has weighed in and provided a lot of guidance for us. And so it’s important to understand how these work. First of all, you’ve got to know that the concept behind this is they want patients to choose their providers based on the quality of care the quality of the physician, the quality of the provider, that that provider is not just simply because someone is giving them a gift. By the way, this is not chiropractic-centric, hospitals deal with this large Cancer Center treatment centers, if you will, they deal with this as well. And they deal with it in a broader scope many times in what we even do in our practices.
But it is important to know what those guidelines look like for gifts and inducements. There are some exceptions. And here are the two biggest ones. One is we start talking about the fact that if it’s small in nature, and then OIG has said is okay, so what is small in nature, they actually give us a specific guideline, the guideline is this, it has to be the gift or discount has to be $15 or less each time. Okay, so $15 or less each time or throughout the entire year, when you look at all of the small gifts that are $15 or less than it has to be less than $75 or less. Okay, so when you look at it in that respect, of course, then maybe you’re looking at it and saying, Well, it’s that’s five $15 gifts. And that’s exactly correct. You can’t be more than that. That’s why a lot of times ongoing discounts and reductions in your fair market value that you’re providing for your services, create problems with your Medicare patients. So even if it’s a small amount for the Medicare patients, right, if it accumulates over the course of a year to be greater than $75. Then at that stage, it would be a violation of the gifts and inducements. Additionally, they really specifically call out the whole waving of co-pays and deductibles. And if you are with a Medicare patient waiving co-pays and deductibles on an ongoing basis then they do consider that to be a violation of the gifts and inducements Act.
Now, you may be looking at me saying Well, Mark, I’ve got a patient that is that has a financial need. They actually lay out really specific rules. And there are some exceptions, and it is possible. We’re going to cover that in a future video because it’s a little bit longer and goes into a bit more detail. But know that it has to be an established policy that you’re offering to all of your patients, not just to your Medicare or your other federally funded program patients, but it has to be offered across the board and there are other restrictions as well. But it is possible in financial hardship cases to help your patients but it has to be a written policy that is equally applied across the board and made available to your patients, all of your patients who have financial need. Hopefully, this information helps you out we’ll catch you next week. But remember gifts and inducements on a federal you know for across the board, especially for your federal federally funded programs that are greater than a small amount. Don’t do that. We’ll catch you next week.