The HHS Office of the Inspector General has given its approval to a healthcare system's plan to offer prompt-pay discounts to patients who pay their share of their medical bills quickly. The system had asked for the OIG's opinion on whether it would violate the anti-kickback statute for rewarding referrals to offer 10 percent to 15 percent discounts before discharge and 5 percent to 10 percent discounts within 30 days. The system feared that they'd be seen as inducing patient self-referrals by encouraging them to buy medical services that might not be needed.
In its advisory opinion, the OIG noted that a safe harbor already exists to protect waivers of coinsurance and deductibles for inpatient services under some circumstances. Primarily, the government doesn't want hospitals to give a discount and then try to get more money from the government by calling the discounted fees bad debt or otherwise try to collect the discrepancy from payers. It held that outpatient discounts don't add up to patient inducements as long as they merely encourage patients to make smart financial decisions rather than get unnecessary care.
To get more details on the decision:
- read this Modern Healthcare piece (reg. req.)
- read the OIG advisory opinion
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