OIG Advisory Opinion Concludes that Transportation Services Payment Plan for Nursing Home Residents May Violate Anti-Kickback Statute

On December 20, 2010, the Department of Health and Human Services, Office of Inspector General (OIG), issued an advisory opinion concerning a transportation provider’s proposal to offer payment plans to skilled nursing facilities (SNFs) for emergency and non-emergency transportation services provided to SNF residents. The advisory opinion concluded that the proposed payment plan could potentially generate prohibited remuneration under the anti-kickback statute (AKS), and the OIG could potentially impose administrative sanctions on the parties if the plan were implemented. The OIG based its opinion primarily on the perceived “link” or “nexus” between the below-cost transportation rates offered in the proposed payment plan and the SNFs’ ability to refer other federally-reimbursable business to the transportation provider.

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