HHS Inspector General assesses new healthcare fraud alert topics

This week the OIG published its annual solicitation of recommendations for new or modified safe harbor provisions under the federal anti-kickback statute.

This week the Department of Health & Human Services Office of Inspector General (OIG) published its annual solicitation of recommendations for new or modified safe harbor provisions under the federal anti-kickback statute, as well as potential topics for new OIG Special Fraud Alerts.

Comments will be accepted until March 2, 2015.

In a separate report, the HHS OIG discussed the following three safe harbor proposals received in response to its 2013 solicitation:

• A new safe harbor protecting free continuing medical education programs offered by hospitals to physicians – The OIG is not adopting this suggestion, stating that the concept of free programs could vary greatly and should be addressed on a case-by-case basis, such as under the advisory opinion process.
• A new safe harbor that would permit healthcare providers and suppliers in certain circumstances to compensate individuals in clinical trials and to provide services related to the clinical trials at no cost, including the waiver of cost-sharing obligations – The OIG is considering the adoption of a safe harbor that would protect the waiver of cost-sharing obligations and possibly other incentives to participants in clinical trials sponsored by certain federal government entities.
• A new safe harbor protecting clinically integrated networks’ entry into contracts with commercial third party payors for value-based payments, including pay-for-performance bonuses and shared savings awards for high quality and cost-effective health care – The OIG believes the issues raised in the proposal require further study.

Debra McCurdy is senior health policy analyst at Reed Smith.