Posted by: Robert Markette
May 14, 2007
Topic: Fraud and Abuse, Self Referral, False Claims

I have been remiss in posting lately, because of speaking engagements. When I am away from the office, work piles up and it is hard to get back to the blog.

When I was speaking at the Indiana Association for Home and Hospice Care a few weeks ago, I was asked an interesting question. A provider asked whether it was a fraud and abuse problem to redistribute supplies from a deceased patient.

The situation the provider relayed was the following: a patient passes away and afterwards the patients family contacts the agency about equipment and supplies the family purchased for the patient. Because the patient has passed, the family has not need for the supplies, but they do not want to simply throw them away. The family asks the agency if they can donate the supplies to the agency so that the agency can give the supplies to another family who could use them.

Of course, this results in the agency giving free items to beneficiaries, which implicates the Civil Monetary Penalty statute. Whenever a provider gives free stuff to Medicare or Medicaid beneficiaries, there is the potential that this is a violation. There is the nominal value exception which allows a provider to give items valued at $10 each up to a maximum of $50 each year.

There is also the practical thought that OIG might not object to a charitable effort such as this. The agency is simply helping patients pass along items that might be of value to someone else. Of course, they might not.

There is a more practical consideration here why do it at all? There are a number of charitable organizations that would be willing to accept the items and provide them to needy patients or their families. You can direct the patients family to such an organization and remove yourself completely from any potential problem. If you are aware of a patient that needs the charity, you can direct them to the organization. If your area does not have such a program, you should talk to the local charitable organizations about such a program.

There was one other issue raised about this hypothetical and that was the potential issues related to infection control. Again, an such concerns are eliminated by directing the patients family to a charitable organization that accepts and distributes such items.

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