Hospital-HME arrangement called a kick-back
June 1, 2004
BURTONVILLE, Md. - In violation of anti-kickback laws, some hospitals have begun asking HMEs, HHAs and hospice providers to perform duties normally handled by discharge planners, according to healthcare attorney Elizabeth Hogue.
Hogue encountered two such arrangements this spring. In each case, the hospital seemed intent on saving money by eliminating discharge planners and contracting with providers to perform discharge planning duties for free. As a conditions of participation in the Medicare program, hospitals must provide discharge planning duties and are reimbursed for doing so. It’s illegal - obviously - for a hospital to collect that reimbursement and not provide the service.
Hogue advised her clients to avoid all such contracts. However, to maintain a good relationship with hospital referral sources, she suggested ways to structure the contracts legally. For example, an HME can work with a discharge planner to facilitate a patient’s transition to the home, but he can’t replace the planner. He can’t, for example, assess and evaluate a patient’s needs, develop discharge plans and document that plan in the patient’s file for free, Hogue said.