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Q&A: Discounting practices

Patient Financial Services Weekly Advisor, March 27, 2009

Q. How does a hospital go about discounting charges to patients with large medical bills?

A. In the same way that a hospital can waive collection of charges for individuals under its indigency policy, a hospital may also offer discounts to those who have large medical bills. Hospitals have flexibility in establishing their own indigency policies.

The Office of Inspector General (OIG) advises that discounts to underinsured patients can raise concerns under the Federal anti-kickback statute, but only where the discounts are linked in any way to business payable by Medicare or other Federal health care programs. In addition, depending on the circumstances, discounts to underinsured patients may trigger liability under the provision of the civil monetary penalties statute that prohibits inducements offered to Medicare or Medicaid beneficiaries.

But again, if no inducement is being offered, neither statute is implicated. Further information on these fraud and abuse issues are available on the OIG Web site.

Source: Center for Medicare & Medicaid Services.

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