Legal risks for providing financial assistance to patients

July 18, 2014
Legal risks for providing financial assistance to patients

(HealthDay)—Physicians need to be aware of the ramifications of providing financial assistance to patients, according to an article published July 8 in Medical Economics.

Physicians may be tempted to provide required funds for patients or waive cost-sharing obligations in cases where finances prevent a patient from receiving needed medical attention. With this in mind, the author of the article, Michael G. DiFiore, J.D., discusses the potential legal risks of providing such assistance.

According to DiFiore, in some states such as New York it is considered misconduct to give patients money for prescription drugs, medical procedures, or insurance premiums, with provision of such funds considered an exercise of undue influence. Furthermore, the federal anti-kickback law and civil monetary penalties law prohibit from making payments to induce business that is paid for by a federal . The routine waiver of cost-sharing requirements under Medicare and Medicaid is viewed by the U.S. Department of Health and Human Services as fraud.

"It is important to note that one-time gifts, whether in the form of cash or cost-sharing forgiveness, are unlikely to trigger scrutiny by an oversight agency," DiFiore writes. "Importantly, should the physician become subject to scrutiny, adherence to a properly drafted charity care policy likely will be a mitigating factor and can potentially insulate the physician from liability."

More information: More Information

Related Stories

AAFP gives context to CMS publication of Medicare payments

May 15, 2014

(HealthDay)—In response to the Centers for Medicare & Medicaid Services' (CMS) publication of Medicare payments to physicians, the American Academy of Family Physicians (AAFP) has developed dedicated online resources to ...

Recommended for you

New weapon in the fight against malnutrition

August 4, 2015

UBC scientists have opened the doors to new research into malnutrition by creating an animal model that replicates the imbalance of gut bacteria associated with the difficult-to-treat disease.

Can four fish oil pills a day keep the doctor away?

July 7, 2015

Fish oil is one of the most popular dietary supplements in the U.S. because of the perceived cardiovascular benefits of the omega-3 it contains. However, scientific findings on its effectiveness have been conflicting. New ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

jellyw
not rated yet Jul 25, 2014
Now it is impossible to get medic aid if you have now money and when the doctor is able to do it for free. For some people it is very expensive to buy health insurance. http://www.cashad...ore.com/ may provide help in such situation.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.