Cash payments or cash equivalents (except rebate checks).The safe harbor specifically excludes the following from the definition of a discount: “Discount,” as used in the regulations, refers to either (1) a reduction in the amount a buyer is charged for an item or service based on an arms-length transaction or (2) a rebate, which is an amount that is described in writing at the time of the purchase but is paid at a later date. The discount safe harbor exempts from the definition of remuneration those discounts on items or services for which the federal government may pay, either fully or in part, under Medicare, Medicaid, or another federal health care program. Arrangements that do not fit within safe harbors are evaluated for fraud and abuse risk on a case-by-case basis based on the totality of the circumstances. However, safe harbor protection is only afforded to those arrangements that precisely meet all of the conditions set forth in the safe harbor. The exception protects “a discount or other reduction in price obtained by a provider of services or other entity under a Federal health care program if the reduction in price is properly disclosed and appropriately reflected in the costs claimed or charges made by the provider or entity under a Federal health care program.” The requirements for immunity for discount arrangements are further enumerated in the federal safe harbor regulations.ĭiscount Safe Harbor To The Anti-Kickback Statuteĭue to the broad language of the federal Anti-Kickback Statute, the Office of Inspector General (“OIG”) has adopted “safe harbor” regulations to protect arrangements that may otherwise violate the statute. The federal Anti-Kickback Statute contains an exception for discounts that may be applicable to an arrangement between a DME supplier and a manufacturer. Many courts have adopted the “one-purpose” test: if one purpose of a payment is to induce referrals, then the Anti-Kickback Statute is violated, regardless of whether the payment is fair market value for otherwise legitimate services rendered.ĭiscount Exception Under The Anti-Kickback Statute The federal Anti-Kickback Statute makes it a felony to knowingly and willfully offer, pay, solicit, or receive any remuneration to induce or reward referrals or items or services reimbursable by a federal health care program. The way to avoid “crossing the line” is for the arrangement to comply with the (i) discount exception to the federal Anti-Kickback Statute and (ii) discount safe harbor to the federal Anti-Kickback Statute. When manufacturers and DME suppliers enter into discount arrangements, it is important that they do not “cross the line” over into kickback territory. AMARILLO, TX – It is a common practice for manufacturers to offer volume-based discounts to DME suppliers to encourage the suppliers to purchase increasing quantities of products.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |