Relaxed beneficiary inducement rules address pandemic need 

relaxed beneficiary inducement rules COVID

Recent guidance from the Office of the Inspector General (OIG) considerably relaxed some of the anti-kickback statute and anti-beneficiary inducement restrictions in light of the COVID pandemic. 

Relaxed beneficiary inducement rules 

As a result of loosened beneficiary inducement restrictions, healthcare organizations are now permitted to offer the following for purposes solely related to COVID-19: 

  • Free lodging to patients and their families in need of it. 
  • Incentives to get vaccinated against COVID – anything from tickets to a local event, discounts at local stores, even cash cards within a maximum limit.
  • Free transportation to and from better staffed locations when staff shortages prevent you from providing care at locations convenient to patients. 
  • Free antibody testing to patients who come in for other tests.  

And thanks to relaxed anti-kickback standards, you’re also permitted to

  • Offer pharmacies free hospital space to administer COVID vaccines.  
  • Make secure telehealth software available to contract doctors so they can see and treat patients without physical office visits, for COVID-19 Purposes. 

Enforcement looks at intent 

Beneficiary inducement and kickback compliance is fairly straightforward. The rules have been on the books for a while, and OIG investigates only when either situation arises in the course of investigating something else.  

But there’s a tricky part, and it has to do with intent. Both the anti-kickback statute and the beneficiary inducement regs are designed to prevent and punish intentionally offering inducements to influence referrals. The assumption behind OIG’s relaxations is that health organizations will act on them just to help patients, with no more nefarious intent.  

Also, though OIG has said it won’t punish health organizations for offering these benefits, the agency still reserves the right to. So you and your hospital’s leaders will need to review and assess how you perform these activities. This way you can make sure there’s no evidence you’re using them to steer federally reimbursed business your way. 

Know about beneficiary inducement reg changes 

Finally, as Omicron starts receding and things start returning to normal, you’ll need to monitor the OIG’s FAQs for future changes. The waiver will terminate automatically once the COVID public health emergency is declared to be over and the Waivers specifically state that “Parties may not use the blanket waivers after the expiration of the Secretary’s authority to grant waivers for the COVID-19 outbreak in the United States.” 

There’s a hard way and an easy way to stay on top of changes. 

The hard way is to keep checking those FAQs every day. If you need an advisory opinion, pay OIG $176 an hour for their lawyers to develop one in a maximum of 60 days. 

The easy way is to let a nationally recognized law firm and YouCompli do it for you. Our compliance system translates the officialese into English and sends you practical policy and implementation templates. 

That way, you’ll serve patients better, stay in compliance, and enjoy huge economies of scale. 

How is your healthcare organization keeping up with regulatory changes like these? Read more about our regulatory monitoring process or schedule a demo.

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