On August 3, 2021, OIG issued an advisory impression, Advisory View No. 21-10, allowing for a dentist to provide no cost regimen and emergency dental products and services to indigent Medicaid beneficiaries who are people of nursing services. Beneath the arrangement, the dentist at the moment offers dental services to inhabitants of nursing amenities as a preferred service provider of a business dental insurance coverage firm in exchange for a for every-member, for every-month payment for all dental expert services presented. The dentist asked for authorization to offer totally free routine and emergency dental companies to indigent Medicaid beneficiaries who reside at the amenities but do not take part in the professional insurance plan provider’s software. Right after very careful thing to consider of the details, OIG determined that the proposed arrangement would not implicate the federal Anti-Kickback Statute (AKS) or Beneficiary Inducements CMP.

OIG viewed as the subsequent aspects in choosing that the federal AKS was not implicated:

  • The provision of cost-free providers did not outcome in referrals being designed for expert services reimbursable by a federal well being care application

  • The dentist did not have an ownership desire or expense fascination in any other entity that delivers a company reimbursable by a Federal well being care application and

  • There was no nexus among the renumeration (no cost assistance) and referrals for providers payable by a federal wellness care program (notice that other referrals for solutions lined by private insurance coverage are not prohibited).

OIG deemed the subsequent components in determining that the Beneficiary Inducements CMP was not implicated:

  • The gain was unlikely to influence a beneficiary’s choice to select a facility just for the cost-free companies becoming delivered

  • The free of charge dental expert services would not be promoted and

  • The solutions would only be out there at services that offer the dental companies to at minimum a person enrollee of the industrial insurance policies supplier.

The whole text of OIG Advisory Feeling No. 21-10 is available in this article.