Washington

Although federal law prohibits Medicare and Medicaid providers from using gifts to solicit beneficiaries' business, a recent advisory bulletin from the U.S. Department of Health and Human Services' Office of Inspector General said that certain small gifts do not count as bribes.

“Given the broad language of the prohibition and the number of marketing practices potentially affected, this bulletin is intended to alert the health care industry as to the scope of acceptable practices,” the OIG explained. To that end, the bulletin offered the following guidelines for Medicare and Medicaid providers:

• Inexpensive gifts or services with a retail value of less than $10 each are not improper unless the total annual value of the gifts exceeds $50.

• Five exceptions to the aforementioned annual gift limit are: cost-sharing waivers based on financial need, properly disclosed co-payment differentials in health plans, incentives to promote preventive-care services, any practice permitted under the federal anti-kickback statute and waivers of hospital outpatient co-payments in excess of the minimum co-payment amounts.

Admitting that there could be further exceptions to the gift-giving rule, OIG said it may solicit public comments on exceptions involving complimentary local transportation and free goods offered in connection with clinical studies. The agency also promised to entertain requests for advisory opinions related to the gift-giving rule.

However, “unless a provider's practices fit within an exception … any gifts or free services to beneficiaries should not exceed the $10 per item and $50 annual limits,” OIG concluded.

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