The HHS' Office of the Inspector General has issued a favorable advisory opinion regarding a hospital's proposal to transport patients and their families from physician offices located on or contiguous to the hospital campus to its acute-care facility in cases where patients are unable to transport themselves.
The OIG opinion states that while the proposed arrangement could potentially generate prohibited remuneration under the Anti-Kickback Statue, the OIG would not impose administrative sanctions in connection with the proposed program.
"This advisory opinion is noteworthy in that the OIG has traditionally taken a negative view towards free transportation services marketed to patients such as by ophthalmologists to cataract patients and where patients are transported out of one catchment area to another," says Scott Becker, JD, CPA, a partner with McGuireWoods.
Proposed arrangement
Under the proposed arrangement, the hospital would provide transportation services free of charge to patients who are unable to transport themselves from physician offices to the hospital for further evaluation and treatment, including admission. Patients would be transported by a licensed EMT employed by the hospital the roughly quarter-mile distance. The hospital would not advertise the service to patients, but would make physicians aware of the service. The hospital estimates it would provide this service to approximately 100 patients per year, and the value of the service could exceed $10 per transport and $50 annually.
OIG analysis
Although the OIG determined the proposed program could potentially violate the Anti-Kickback Statute and the Civil Monetary Penalty in that the transportation service could induce federal health program beneficiaries to use the hospital's services, the OIG determined it would not pursue administrative sanctions for six key reasons:
1. Proposed service would not be limited to federal healthcare program beneficiaries. Instead, the service would be open to any patient who met the hospital's written policy establishing required need.
2. The type of transportation is reasonable. That is, it would not include expensive transportation such as limousines.
3. Transportation would only be offered locally. Patients would be transported only approximately one-fourth of a mile.
4. The service would not be advertised to patients. The hospital would not advertise the proposed arrangement.
5. Transportation may be difficult for certain patients. According to the hospital, the availability of local public transportation and parking is limited.
The OIG opinion states that while the proposed arrangement could potentially generate prohibited remuneration under the Anti-Kickback Statue, the OIG would not impose administrative sanctions in connection with the proposed program.
"This advisory opinion is noteworthy in that the OIG has traditionally taken a negative view towards free transportation services marketed to patients such as by ophthalmologists to cataract patients and where patients are transported out of one catchment area to another," says Scott Becker, JD, CPA, a partner with McGuireWoods.
Proposed arrangement
Under the proposed arrangement, the hospital would provide transportation services free of charge to patients who are unable to transport themselves from physician offices to the hospital for further evaluation and treatment, including admission. Patients would be transported by a licensed EMT employed by the hospital the roughly quarter-mile distance. The hospital would not advertise the service to patients, but would make physicians aware of the service. The hospital estimates it would provide this service to approximately 100 patients per year, and the value of the service could exceed $10 per transport and $50 annually.
OIG analysis
Although the OIG determined the proposed program could potentially violate the Anti-Kickback Statute and the Civil Monetary Penalty in that the transportation service could induce federal health program beneficiaries to use the hospital's services, the OIG determined it would not pursue administrative sanctions for six key reasons:
1. Proposed service would not be limited to federal healthcare program beneficiaries. Instead, the service would be open to any patient who met the hospital's written policy establishing required need.
2. The type of transportation is reasonable. That is, it would not include expensive transportation such as limousines.
3. Transportation would only be offered locally. Patients would be transported only approximately one-fourth of a mile.
4. The service would not be advertised to patients. The hospital would not advertise the proposed arrangement.
5. Transportation may be difficult for certain patients. According to the hospital, the availability of local public transportation and parking is limited.
To read the full OIG advisory opinion on the hospital transport service, click here (pdf).