According to a new advisory opinion issued by the U.S. Department of Health & Human Services’ Office of Inspector General, healthcare providers may be able to use free gift cards to encourage patients in capitated Medicaid managed care plans to receive clinical services.
In the opinion, a federally qualified health center (FQHC) asked the OIG whether it could offer free grocery store gift cards to certain patients in capitated Medicaid managed care plans. The goal of the gift card program was to incentivize patients to receive health screenings and other clinical services at the FQHC.
The OIG stated that, in general, the Anti-Kickback Statute prohibits Medicare and Medicaid providers from providing “giveaways” to patients in order to induce them to receive clinical services. However, the OIG approved this specific gift card program because the only eligible patients were enrolled in capitated Medicaid plans. Under these plans, the FQHC’s reimbursement would not be based on the nature or number of services that the FQHC provides to the patients. Thus, the gift card program would not result in increased costs to the Medicaid program.
The opinion represents an interesting exception to the general rule that providers should not provide free goods and services to patients to incentivize them to receive clinical services. View the full opinion.
