BC Advantage - 2021 Issue 9

Waiving Copays Associated with Medicare - Just as Illegal Now as it Was in 1994

On December 19, 1994, the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG) published a Special Fraud Alert in the Federal Register related to the waiver of copays, with the intention of alerting the public about "its concern about possible widespread and abusive health care industry practices, and seeking wider dissemination of information to the general public." Prior to 1994, HHS-OIG issued five previous Special Fraud Alerts addressing specific areas, which may cause the federal Anti-Kickback Statute to be violated. The five areas were: (1) joint venture arrangements; (2) routine waiver of Medicare...

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