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HHS OIG Issues Request for Information Regarding the Anti-Kickback Statute and Beneficiary Inducements Civil Monetary Penalty

August 31, 2018

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PRESS CONTACTS
Phoebe Ramsey, Sr. Regulatory Analyst, Quality & Payment Policy

The Department of Health and Human Services (HHS) Office of the Inspector General (OIG) Aug. 27 released a Request for Information (RFI) regarding the anti-kickback statute and beneficiary inducements civil monetary penalty (CMP) seeking input from the public on addressing regulatory provisions in Medicare and state health programs that may act as barriers to coordinated or value-based care. This follows a similar RFI released by CMS earlier this year requesting feedback on regulations regarding physician self-referrals (also know as the Stark law) and barriers to coordinated care.

The RFI poses questions specific to four topic areas to help inform the OIG on how to balance flexibility for industry stakeholders to provide efficient, well-coordinated, patient-centered care with protections against harms caused by fraud and abuse:

  • Promoting Care Coordination and Value-Based Care
    • Types of Arrangements
    • Safe Harbors or Exceptions
    • Definitions of Critical Terms
  • Beneficiary Engagement
    • Beneficiary Incentives
    • Cost-Sharing Obligations
  • Other Topic Areas
    • Current Fraud and Abuse Waivers
    • Cybersecurity-Related Items and Services
    • Accountable Care Organization (ACO) Beneficiary Incentive Program and Telehealth sections of the Bipartisan Budget Act of 2018 (H.R. 1892)
  • Intersection of Physician-Self-Referral Law and Anti-Kickback Statute

Comments are due Oct. 26.

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