The Department of Health and Human Services Office of the Inspector General (“OIG”) has created a website to document its response to the COVID-19 pandemic. OIG’s COVID-19 Portal contains information on OIG’s response to the crisis, including information regarding the suspension of administrative sanctions for waiving cost-sharing for telehealth services, updates to OIG’s Work Plan, and resources to combat COVID-19 scams.
Telehealth Cost Sharing Waiver
On March 17, 2020, OIG issued a policy statement announcing its suspension of administrative sanctions for providers who waive cost-sharing with beneficiaries of federal health care programs. Typically, waiver of cost sharing with beneficiaries implicates the Anti-Kickback Statute, prohibitions on inducements to beneficiaries, civil monetary penalties, and exclusion from federal healthcare programs. Now, pursuant to the policy statement, OIG will not seek administrative sanctions where the following conditions are all met:
- A provider waives or reduces cost sharing amounts for telehealth services provided consistent with then-applicable coverage and payment rules; and
- The services are provided during the COVID-19 public health emergency declaration period beginning on January 27, 2020 announced by Secretary Alex Azar.
Work Plan Updates
OIG has added five new review and reporting items to its Work Plan, its list of current policy priorities and plans, relating to COVID-19. The new Work Plan items include emergency preparedness and response reviews, COVID-19 hospital response reporting, and overall response review and reporting.
Anti-Fraud
In addition to suspension of administrative sanctions for telehealth services cost sharing waiver and updates to its Work Plan, OIG has included information about consumer scams related to COVID-19 testing. OIG has provided tips to consumers for avoiding COVID-19 scams and has included information on how to report suspected scams.
Questions
Kronick attorneys across all of the firm’s practice groups – Public Agencies, Natural Resources, Labor & Employment, and Business/Healthcare – will continue to provide clients and the community with ongoing updates and advice regarding COVID-19 related issues as developments warrant. Please feel free to contact us for assistance with issues arising from the current health crisis.
Jennifer Scott
jscott@kmtg.com | 916-321-4349