![]() ![]() The routine waiver of a patient’s copayment obligations implicates this prohibition because it reduces the amount that the patient pays for services, and may therefore induce the patient to seek more services that are payable by Medicare. The federal antikickback statute prohibits the offering of any remuneration to induce a person to purchase or order any service for which payment may be made under Medicare. Discounts with Respect to MedicareĪlthough the Centers for Medicare and Medicaid Services (CMS) and the Office of Inspector General for the Department of Health and Human Services (OIG) are not alarmed by the occasional waiver of copayment obligations – due to financial hardship or uncollectibility – the routine waiver of copayment obligations under Medicare is clearly problematic. Consequently, a provider must exercise discretion and sound judgment when offering any discount to patients. § 1320a-7b, or be accused of false billing by private insurance carriers not receiving the discount. A provider who routinely discounts or waives a patient’s copayment or deductible (collectively referred to as copayment) obligations, for example, can run afoul of the federal antikickback statute, 42 U.S.C. However, providers must exercise caution because offering discounts to patients can implicate various federal and state laws. Offering patients a time-of-service discount may be a useful and permissible billing practice under limited circumstances when the discount reflects the administrative savings to the practice. By extending a discount to patients who pay out of pocket at the time of service or seek reimbursement from their insurance company at a later date, a provider can reduce the administrative costs associated with processing insurance claims as well as the uncertainty and delay of billing and collecting for services rendered. One potential way for providers to accomplish these goals is to discount their usual and customary fees for patients who pay in cash at the time of service. In a difficult economic environment, many health care providers are actively trying to increase cash flow and reduce administrative expenses. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |