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Information Articles: Frequently Asked Questions

Gifts and Inducements

Wednesday, May 10, 2017   (0 Comments)
Posted by: ICS Staff
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Gifts and Inducements 

 

Q.:  May I give gifts to patients to thank them for referring new patients to my office?

 

A.:  The ICS advises against this practice for many reasons.  The OIG believes that offering valuable gifts to beneficiaries to influence their choice of a Medicare or Medicaid provider raises quality and cost concerns. Beneficiaries are induced to use a health care provider not based on his or her qualifications, but because of the gifts provided. Offering a gift or cash in exchange for referrals could be construed as an illegal “kickback,” or payment to the referring individual of a portion of the medical charges.

 

Technically federal law allows providers to offer one time gifts that have a retail value of $15 or less, or no more than $75 per year in the aggregate.  Therefore, you are permitted to offer gifts if they do not exceed these amounts. Gifts such as coupons for free exams, 30 minute massages, adjustment, and x-rays would yield a fair market value greater than the allowable amount. However, some services, such as spinal screenings, very well may have a fair market value of $15 or less.  

 

Offering discounted or free examinations and x-rays could also place you out of compliance with other provider network contracts you have signed.  You will need to check the terms of your provider agreements to determine whether they permit you to provide these services.  

 

In addition to violating federal laws and network agreements, giving gifts or cash for referrals can easily violate the state fee splitting statute regarding services provided to any patients, not just Medicare or Medicaid patients.  The Illinois Medical Practice Act prohibits a physician from dividing, sharing or splitting any fee for professional services with any person in exchange for a referral.  If the gift or cash is construed as a division or sharing of fees, the physician’s license may be disciplined up to suspension or revocation.

 

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