Reed Smith Client Alerts

The Office of Inspector General (OIG) of the Department of Health Human Services (HHS) is seeking input on Medicare and State Health Care Programs: Fraud and Abuse; Request for Information Regarding the Anti-Kickback Statute and Beneficiary Inducements CMP. The OIG characterizes this request for information (RFI) as part of HHS’s effort “to transform the health care system into one that better pays for value.” The RFI seeks to identify ways to amend or add new safe harbors to the Anti-Kickback Statute (AKS) and exceptions to the beneficiary inducements provisions of the Civil Monetary Penalty (CMP) statute, in order to foster arrangements that promote care coordination and advance the delivery of value-based care.

Authors: Elizabeth B. Carder-Thompson Shaylynn Veeder Selina P. Coleman Robert J. Hill Jeff Layne Carol Colborn Loepere Debra A. McCurdy Joseph W. Metro Katie C. Pawlitz Frederick Robinson

The RFI seeks to identify ways to amend or add new safe harbors to the Anti-Kickback Statute (AKS)1 and exceptions to the beneficiary inducement provisions of the Civil Monetary Penalty (CMP) statute,2 in order to foster arrangements that promote care coordination and advance the delivery of value-based care. The OIG notes that, through internal discussions and input from external stakeholders, it has identified the broad reach of these provisions as “potential impediment[s] to beneficial arrangements that would advance coordinated care.” 

The OIG will accept comments on the RFI until October 26, 2018.