The Office of Inspector General (OIG) has increased the value of permissible gifts that may be made to Medicare beneficiaries without running afoul of the civil monetary penalty (CMP) provision prohibiting beneficiary inducements (Social Security Act § 1128A(a)(5)). The statute provides for CMPs of up to $10,000 for offers or transfers to a Medicare or Medicaid beneficiary of any remuneration that the person knows or should know is likely to influence the beneficiary's selection of a particular provider, practitioner, or supplier of Medicare or Medicaid payable items or services, with certain exceptions.
Congress authorized inexpensive gifts of nominal value to be provided without violating this provision, which the OIG interpreted in 2000 to mean a retail value of no more than $10 per item or $50 in the aggregate per patient on an annual basis. The OIG has determined that these figures should be adjusted. Specifically, in a December 7, 2016 statement, the OIG announced that it is now interpreting "nominal value" as having a retail value of no more than $15 per item or $75 in the aggregate per patient on an annual basis. The OIG continues to state that such items may not be cash or cash equivalents.
This article is presented for informational purposes only and is not intended to constitute legal advice.