October 24, 2018 – Two recent advisory opinions from the Office of the Inspector General (OIG) at HHS are demonstrating why current healthcare fraud and abuse laws are not aligned with value-based payment and care delivery.
The federal watchdog recently announced that it would not take enforcement action against two separate proposals to provide incentive payments to providers for increased preventative health screenings and create a value-based purchasing arrangement for surgical products.
In the most recent advisory opinion issued on Oct. 11, 2018, OIG determined that a safe harbor from the anti-kickback statute would apply to a proposed incentive payment arrangement between a Medicaid managed care organization and its providers.
Source: OIG: Healthcare Fraud Exceptions for 2 Value-Based Payment Models / RevCycle Intelligence