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Health System Free Shuttle Rides for Patients will Not Result in Sanctions

on Monday, 23 November 2015 in Health Law Advisory: Zachary J. Buxton, Editor

Over the years, the OIG has issued a number of advisory opinions regarding various proposals from hospitals to provide transportation for patients. Some have been found not to draw prosecution and sanctions and others have not fared so well. The typical contours of a transportation program that does not risk prosecution under the anti-kickback statute or the civil monetary penalties statute prohibiting inducements to Medicare and Medicaid beneficiaries typically involves local transportation that does not bypass other competing providers, is basic, rather than luxury in nature; is not targeted to Medicare or Medicaid beneficiaries or high dollar services; and is not advertised– patients have typically selected the hospital for services before being advised of the availability of the transportation service.

The latest advisory opinion (Adv. Opn 15-13, issued October 21, 2015) addressing transportation involves a rural health system’s proposal to operate two shuttle vans according to established schedules from designated pick-up sites to the facilities of the Health System from 8 a.m. to 6 p.m., 10 times per day. Transportation services would not be publicized to the general public, rather employed providers within the health system would advise current patients of the service as needed. All patients would be eligible, no selection would be based on type of insurance coverage. The OIG enumerated the following characteristics of the proposal as safeguards mitigating the risk of fraud and abuse:

  • the shuttle rides wouldn’t be offered based on the volume or value of federal health care business that would be generated by any given patient receiving the service;
  • the shuttle was not luxurious and offered no ambulance amenities;
  • the shuttle drivers were not paid on the basis of then number of patients transported;
  • the cost of the shuttle were borne by the health system and were not billed to Medicare or other payers; and
  • patients would not receive marketing materials during shuttle rides.

Hospitals considering transportation services should adhere to the safeguards reinforced in this most recent opinion.

Julie A Knutson

1700 Farnam Street | Suite 1500 | Omaha, NE 68102 | 402.344.0500