The vendor proposed selling hospitals a package of services involving a patient liaison who would help patients follow discharge instructions, with the aim of reducing readmissions and therefore helping hospitals avoid cuts to their Medicare reimbursement. The hospital would pay a flat fee for implementation services, which could include electronic health record data integration, and a per-patient fee for specific services the hospital chooses for individual patients.
The vendor has a separate sales department from its parent company and would not receive payment for any drug sales. In addition, neither the vendor nor the patient liaison would recommend patients seek care at providers outside of the patient’s designated regular providers.
The OIG concluded that the proposal “presents a sufficiently low risk of fraud and abuse under the antikickback statute” and “would not constitute grounds for the imposition of civil monetary penalties.”
More Articles on Hospital Readmissions:
Colorado Hospitals Cut All-Cause Readmissions 43%, Save Nearly $3M
Study: Hip Surgery Readmissions Could Cost Hospitals $11k if CMS Doesn’t Pay
Ohio State, Columbus Neighborhood Health Centers Partner to Reduce Cardiac Readmissions
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.