Inducement Threshold Updated by OIG
The Department of Health and Human Services Office of Inspector General (OIG) issued a policy statement December 7 increasing what constitutes a gift of “nominal value” to Medicare and Medicaid beneficiaries for purposes of avoiding civil monetary penalties.
Under Section 1128A(a)(5) of the Social Security Act, enacted as part of HIPAA:
a person who offers or transfers to a Medicare or Medicaid beneficiary 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 may be liable for civil monetary penalties (CMPs) of up to $10,000 for each wrongful act.
In 2000, OIG interpreted the terms “inexpensive” or “nominal value” to mean a retail value of no more than $10 per item, or $50 in the aggregate per patient, on an annual basis. As of December 7, “nominal value” has be re-defined as having a retail value of no more than $15 per item or $75 in the aggregate per patient, on an annual basis. Such remuneration cannot include cash or items similar to cash, such as gift cards.