On October 21, 2015, the HHS Office of Inspector General (OIG) released Advisory Opinion No. 15-13, stating that it would not impose administrative sanctions against members of a health system for offering free van shuttle services to certain medical facilities within the health system.
The Proposed Arrangement
Under the proposed arrangement, the health system would provide free van shuttle services to patients of health system physicians and patients of private physicians located at one of the health system’s community hospitals. The health system proposed to offer two shuttle services. The first shuttle would provide transportation between the health system’s main medical center, a community hospital, an ambulatory surgery center and a designated “drop-off and pick-up location.” The second shuttle would provide transportation between the main medical center and another community hospital within the health system.
Potentially Risky Arrangements
OIG’s analysis is instructive for other providers contemplating free transportation arrangements. Especially instructive is OIG’s analysis of suspect transportation arrangements to include the following:
- Arrangements that selectively provide free transportation services to patients based on their “diagnoses, conditions, treatments or type of insurance coverage;”
- Transporting patients by air, on luxury vehicles or at a level where patients could receive ambulance services.
- Paying drivers based on the number of people or patients they transport;
- Offering free transportation to patients residing outside of a provider’s primary service area;
- Marketing or advertising free transportation services to the general public or having drivers market or advertise healthcare items or services during transportation;
- Shifting the costs of free transportation services to Medicare, state run programs, other payers or individuals;
- Subsidizing the practice of private physicians by providing their patients with access to those physicians’ practices; and
- Providing free transportation services when local public transportation is readily available.
*Wendy Wright is admitted only in North Carolina. Her practice is supervised by principals of the firm admitted in the District of Columbia.