OIG okays providing modest hotel and meal accommodations for rural and financially needy patients.
The U.S. Department of Health and Human Services Office of Inspector General (OIG) recently issued an advisory opinion interpreting the finalized rules related to the beneficiary inducement civil monetary penalties (CMP) law. In a previous blog post, we discussed the OIG final rule that codified three exceptions to the definition of remuneration under the beneficiary inducement provision of the CMP law. The OIG advisory opinion approved an arrangement under the “promoting access to care” exception to the CMP law by authorizing a hospital system to provide free or reduced-cost lodging and meals to certain hospital patients, including federal healthcare program beneficiaries.
Under the proposed arrangement, the hospital would provide reduced-cost, and sometimes even free, hotel accommodations to eligible patients for one night before, and up to two nights after, treatment at the hospital. The hospital also proposed to provide free or reduced-cost hospital meals for each overnight hotel stay. To qualify for these benefits, patients had to satisfy all of the following criteria:
- Reside 90 or more miles from the hospital in either a designated medically underserved area of the state or a designated professional health shortage area;
- Have a household income that does not exceed 500 percent of the federal poverty level and meet the criteria in the hospital’s written financial assistance policy; and
- Meet one of the follow circumstantial requirements:
- For lodging and meals prior to treatment: the patient must be required to present at the hospital before 10:00 a.m.
- For lodging and meals following treatment: The patient must have no need for on-site care but must be required to attend a follow-up appointment or return for surgery within 48 hours.