An advisory opinion from HHS' inspector general's office may further delineate the boundaries between kickback payments and charity care. The office evaluated an unnamed charitable program that acts as an intermediary between needy patients and their insurers, employers and creditors to defray prescription drug costs. The program is supported by donations from drugmakers and providers. According to the opinion, which applies only to the charity requesting it, the setup "effectively insulates beneficiary decisionmaking from information attributing the funding of their benefit to any donor, (so) it appears unlikely that donor contributions would influence any Medicare beneficiary's selection of a particular provider, practitioner or supplier."
Healthcare lawyers said one key to keeping a charity-care program clear of antikickback laws is divorcing the program from patient referrals. L. Edward Bryant Jr., who heads the healthcare practice in the Chicago office of Gardner Carton & Douglas, said hospitals intending to establish similar programs should seek advisory opinions as well. "This is a good example of what hospitals could do under similar fact circumstances," Bryant said. Read the opinion. -- by Mark Taylor