OIG: Readmission Reduction Service Can Proceed
Aug. 19—A federal watchdog cleared a drug company subsidiary to contract with hospitals to provide post-discharge services to patients aimed at avoiding readmission penalties.
The Office of Inspector General issued an Aug. 16 advisory opinion to an unnamed wholly owned drug maker subsidiary that its readmission reduction service for hospitals would not result in anti-kickback penalties.
The subsidiary specified a number of ways that its actions were unconnected to its parent company.
Under the arrangement, the contractor would provide hospitals with a package of services specifically designed to help providers avoid payment cuts under the Medicare Hospital Readmissions Reduction Program, which penalizes hospitals when patients with certain conditions are rehospitalized at relatively higher rates.
The contractor's program would provide post-discharge services to patients with the conditions tracked by the readmissions program—acute myocardial infarction, congestive heart failure, and pneumonia. Services provided under the arrangement included contact with a "patient liaison" for patients within 48 hours of discharge to ensure they understood and planned to follow their discharge plan.
The service "poses a low risk of fraud and abuse under the anti-kickback statute," the OIG opinion concluded.In fact, "the services could potentially save the federal healthcare programs money if the proposed arrangement is successful in furthering its goal of decreasing excess hospital readmissions," OIG opinion stated.
Publication Date: Monday, August 19, 2013