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OIG Updates Threshold for Gifts of “Nominal Value”

on Friday, 20 January 2017 in Health Law Advisory: Zachary J. Buxton, Editor

On December 7, 2016, the Office of Inspector General (OIG) of the Department of Health and Human Services updated the threshold for gifts of “nominal value” for Medicare beneficiaries from $10 to $15 per item and $50 to $75 in total for a patient on an annual basis.

The Civil Monetary Penalties law (42 USC § 1320a-7a) prohibits any person from giving a Medicare or Medicaid beneficiary anything of value that that person either knows or should know will influence that beneficiary’s decision to receive services reimbursed by Medicare or Medicaid from a particular provider, practitioner, or supplier.

The OIG has long exempted gifts of “nominal value” from this definition as long as the gift is not cash or a cash equivalent. “Nominal value” was long defined as $10 per occurrence or $50 per year per patient. For “nominal value,” think of the branded stress balls, pencils, or notepads provided by some hospitals or physician clinics at health fairs.

OIG’s new thresholds are $15 per occurrence and $75 in the aggregate per patient per year. OIG announced the increase in a document titled “Office of Inspector General Policy Statement Regarding Gifts of Nominal Value to Medicare and Medicaid Beneficiaries.”

Zachary J. Buxton

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