Gifts to patients may constitute a felony if in violation of the OIG rules

When giving gifts to Medicare-age patients, use caution and check with the OIG for all rules that apply. Gifts that are perceived to be an inducement to patients to choose your clinic over other providers, may be in violation of HIPAA regulations.. Beyond civil monetary penalties, a provider could be excluded from all plans or face felony conviction. Review this information from the OIG to see how this law is interpreted.

Section 1128A(a)(5) of the Act (the “CMP”) provides for the imposition of civil monetary penalties against any person who offers or transfers remuneration to a Medicare or State health care program (including Medicaid) beneficiary that the benefactor knows or should know is likely to influence the beneficiary’s selection of a particular provider, practitioner, or supplier of any item or service for which payment may be made, in whole or in part, by Medicare or a State health care program (including Medicaid). The OIG may also initiate administrative proceedings to exclude such party from the Federal health care programs. Section 1128A(i)(6) of the Act defines “remuneration” for purposes of the CMP as including “transfers of items or services for free or for other than fair market value.” The OIG has previously taken the position that “incentives that are only nominal in value are not prohibited by the statute,” and has interpreted “nominal in value” to mean “no more than $10 per item, or $50 in the aggregate on an annual basis.” 65 Fed. Reg. 24,400, 24,410–11 (Apr. 26, 2000) (preamble to the final rule on Civil Money Penalties).