OIG Advisory Opinion: Charity Can Pay Some Copays for Low-Income Patients

January 19, 2015 – In The News
Part B News

William Maruca was quoted in the Part B News article “OIG advisory opinion: Charity can pay some copays for low-income patients.” Full text can be found in the January 19, 2015, issue, but a synopsis is below.

An Office of Inspector General (OIG) advisory opinion offers more evidence that charitable organizations are able to pay part of the cost of indigent patients’ treatment without triggering the anti-kickback statute and leading to civil monetary penalties, as long as they observe certain guidelines.

This opinion reviews 501(c)(3) the intent of an anonymous Crohn’s disease and ulcerative colitis charity to pick up the copayments on the drug regimens prescribed for treatment of patients suffering from those diseases.

The OIG appeared satisfied that there would be no inducement by remuneration for referrals that would trigger the anti-kickback statute.

Physicians can help their patients by recommending that they contact such organizations if their ability to pay their bills were in doubt without fear of violating federal law.

William Maruca explained he thinks that “the OIG would allow physicians and providers to publicize the charitable assistance available through the foundations and steer their indigent patients to the foundations for help.”