It’s a sad fact that sometimes basic transportation needs get in patients’ way of accessing health care, and no health care provider wants to see their patients go without care just because they can’t get rides to the clinic.
While it may seem like paying for a patient’s Uber ride, cab fare, or bus ticket is clearly an altruistic act, providers have to remember that the Anti-Kickback Statute can come into play when gifts are given to patients. And providing transportation or paying the cost of a ride are just the types of gifts that can be considered kickbacks, according to the Office of the Inspector General for the U.S. Department of Health and Human Services (the “OIG”). Fortunately, recent updates to the Anti-Kickback Statute give providers a path to compliance while still allowing them to help patients with transportation.
|Wait, what’s the Anti-Kickback Statute again?
|Put simply, the federal Anti-Kickback Statute prohibits health care providers from giving or receiving anything of value in exchange for referrals for health care services paid for by the federal government. This includes providers giving Medicare beneficiaries something of value – like transportation – in exchange for getting treatment from them.
Updates to the Anti-Kickback Statute that took effect earlier this year include a safe harbor for local non-emergency transportation. In order to fall under this safe harbor, all of the following elements must be met:
- The availability of the free or discounted transportation is set forth in a policy, which is applied uniformly and consistently.
- The availability of the transportation is not determined in a manner related to the past or anticipated volume or value of Federal health care program business.
- The transportation provided does not involve air, luxury, or ambulance-level transportation.
- The provider does not publicly market or advertise the free or discounted local transportation services, and no marketing of health care services takes place during the transportation.
- The transportation is only provided to “established patients” traveling to or from the health care provider. The definition of “established patients” includes new patients who have contacted the provider to make an appointment.
- The transportation is provided within a 25-mile radius from the provider’s location in urban areas and within a 75-mile radius in rural areas.
- The purpose of the transportation is to obtain medically necessary items and services.
For assistance reviewing your patient transportation practices, or for help preparing a patient transportation policy, contact Attorney Lora L. Zimmer at [email protected] or 920-257-2214.
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