OIG opinion: Free home health visits are not kickbacks

freeThe U.S. Department of Health and Human Services Office of Inspector General recently issued an opinion that a home healthcare provider’s policy to offer free introductory visits to patients who have already chosen it as their provider does not violate the federal anti-kickback statute.

In its request for an advisory opinion, the home healthcare provider stated that patients who choose their services do so without any involvement from the home healthcare provider and with no remuneration to referral sources. Generally, patients are provided with a list of potential home healthcare agencies by their physician, hospital discharge planner or case manager.

Once they select a home healthcare provider, they are contacted to see if they would like a free introductory visit, the purpose of which is to facilitate the patients transition to home healthcare services in an effort to increase compliance with the post-acute treatment plan.

If the patient accepts the offer, they are visited by a liaison who can (1) provide them with an overview of the home health experience, (2) give them written materials with a list of contact information for some of the home healthcare agency’s administrative and clinical employees, and (3) give them pictures of those on the home healthcare team who would provide their services. This visit can take place in the hospital, in a physician’s office or in the patient’s home. If non of those options are available a patient can receive the information via email.

No diagnostic or therapeutic services that would be reimbursed by a federal healthcare program (i.e. Medicare or Medicaid) are provided at the time of the visit.

The anti-kickback statute makes it a criminal offense to knowingly and willfully offer, pay, solicit, or receive any remuneration to induce or reward referrals of items or services reimbursable by a federal health care program.  The OIG noted that the federal anti-kickback statute is not implicated if remuneration is not offered, paid, solicited, or received.  Similarly, the Civil Monetary Penalties Law (CMP) is not implicated if remuneration is not offered or transferred to a Medicare or state healthcare program beneficiary.

The OIG found that the introductory visits offered by the home healthcare provider do not provide any actual or expected economic benefit to patients, and therefore do not constitute remuneration for the following reasons:

  • During the introductory visits patients receive only information about the home health agency’s employees, including photographs of patients’ care team members, and an overview of the home health experience.
  • The primary purpose of these activities is to facilitate patients’ transitions to home health services in an effort to increase compliance with their post-acute treatment plans.
  • The liaison does not provide any federally reimbursable diagnostic or therapeutic services during the introductory visits.
  • The introductory visits provide a means to help ensure patients’ personal safety by familiarizing them with members of the care team who will later come into their homes.

It’s important to note that the advisory opinion is limited in scope to the specific arrangement described in the OIG opinion letter and is not applicable to other arrangements, even those which appear similar in nature or scope.

If you have any questions or concerns about your healthcare facilities’ business arrangements, please contact the Health Law Offices of Anthony C. Vitale for a complimentary consultation.