Substance Use Disorder Treatment Incentive Program Receives Go Ahead From the OIG

by  Raquel Shumway
Apr 22nd, 2022

Creating incentives for individuals participating in a substance use disorders (SUD) program has always been challenging due to concerns over violating Federal laws such as the Anti-Kickback Statute (AKS) and the  the Beneficiary Inducements Civil Monetary Penalties. That limit makes it hard for SUD programs seeking to incentivize treatment to encourage compliance.

DynamiCare Health Inc. has developed a contingency management program (CM) for those dealing with substance use disorders. CM “addresses the brain’s reward response in ways that conventional counseling and medications often cannot.” Over a course of 50 years, it has shown that these types of programs are  effective. 

DynamiCare Health requested an opinion from the OIG who reviewed their request and determined that there is low risk for fraud and abuse and has offered their opinion on the request of DynamiCare Health, Inc.  

NOTE: OIG states that

If other programs wish to seek an advisory opinion, contact the OIG and make a request.

The advisory opinion No. 22-4 states that “based on the relevant facts certified in your request for an advisory opinion…..the OIG will not impose administrative sanctions on the Requestor in connection with the Arrangement under sections 1128A(a)(7) or 1128(b)(7) of the Act, as those sections relate to the commission of acts described in the Federal anti-kickback statute;” They also state that they “will not impose administrative sanctions on Requestor in connection with the Arrangement under the Beneficiary Inducements CMP or section 1128(b)(7) of the Act, as that section relates to the commission of acts described in the Beneficiary Inducements CMP.

Besides the fact that this opinion applies only to the requestor, the OIG opinion does add a few other limitations:

Note:  As stated above, this opinion does not obligate any agency other than the Department of Health and Human Services.

Knowing that the OIG has stated that it won’t impose sanctions opens the door to using the contingency management program as a good option for patients who would benefit from a substance use disorder or Contingency Management program.