HHS-OIG Raises ‘Nominal Value’ for Gifts to Medicare and Medicaid Beneficiaries

On Dec. 7, 2016, just in time for the holiday season, the Office of Inspector General (OIG) released a policy statement regarding the nominal value of gifts that healthcare providers may give to Medicare and Medicaid beneficiaries. In short, the OIG now allows gifts of “nominal value,” no more than $15 per item or $75 in aggregate per patient on an annual basis, which marks an increase from the limits set in 2000 of $10 per item or $50 in aggregate per patient annually.

Under section 1128A(a)(5) of the Social Security Act, enacted as part of the Health Insurance Portability and Accountability Act of 1996, a person who offers or transfers to a Medicare or Medicaid beneficiary any remuneration that the person knows or should know is likely to influence the beneficiary’s selection of a particular provider, practitioner, or supplier of Medicare or Medicaid payable items or services may be liable for civil monetary penalties of up to $10,000 for each wrongful act. Remuneration includes waivers of copayments and deductible amount and transfers of items or services for free or other than fair market value.

Source: http://www.lexology.com/library/detail.aspx?g=33daed46-3f90-4f61-b42b-c2f7dae10e44

Leave a Reply

Your email address will not be published.