Recently, we received a question from a D.C. about announcing an office opening. The doctor was considering including an offer of a free consultation and exam and wondered if this was a common practice, how to handle billing, etc.

Beware of what you read in a marketing magazine article or book or learn in a practice management seminar.  Although the author may have good intentions, they may not be aware of compliance issues and the law. 

As a Certified Compliance Specialist (MCS-P), I continue to see violations of the Anti-Kickback Statute. 

Simply stated, it is illegal to offer free services or inducements to Medicare, Medicaid or Champus. Furthermore, certain states, IPAs and PPOs do not allow any offer of free services.

The anti-kickback statute makes it a criminal offense to knowingly and willfully offer, pay, solicit, or receive any remuneration to induce or reward referrals of items or services reimbursable by a Federal health care program. Where remuneration is paid purposefully to induce or reward referrals of items or services payable by a Federal health care program, the anti-kickback statute is violated.

By its terms, the statute ascribes criminal liability to parties on both sides of an impermissible "kickback" transaction. For purposes of the anti-kickback statute, "remuneration" includes the transfer of anything of value, directly or indirectly, overtly or covertly, in cash or in kind.

The statute has been interpreted to cover any arrangement where one purpose of the remuneration was to obtain money for the referral of services or to induce further referrals. Violation of the statute constitutes a felony punishable by a maximum fine of $25,000, imprisonment up to five years, or both.

Conviction will also lead to automatic exclusion from Federal health care programs,including Medicare and Medicaid. The OIG has previously taken the position that "incentives that are only nominal in value are prohibited by the statute," and has interpreted "nominal value to be no more than $10 per item, AND no more than $50 in the aggregate on an annual basis."  

This means that you cannot offer anything of value for free or other than fair market value unless it is $10 or less and no more than five times per year.

Dr. Fucinari is practices full-time in Decatur, IL. In addition, he is a part-time instructor at Logan College of Chiropractic. He has earned the designations of Certified Chiropractic Sports Physician (C.C.S.P.), Certified Insurance Consultant, Certified Medical Compliance Specialist (MCS-P) and Certified Medical Compliance Instructor (MCS-I).