Say ‘thank you’ but play it safe

Wednesday, December 31, 2008

YARMOUTH, Maine--When it comes to thanking referral sources for their business, providers continue to be wary of crossing the line.
That’s why provider Mark Gielniak sticks to dropping off pens, calendars or the occasional trinket when he calls on referral sources.

“It’s nothing major,” said Gielniak, vice president of Diabetes Plus in Warren, Mich. “It’s just little $5-and-under items with our name on it.”

Providers should be cautious, say industry attorneys. Medicare anti-kickback and Stark laws strictly prohibit offering inducements for referrals. The laws were updated in late 2007, but many providers remain confused, they say.

In a nutshell, providers must stay within an annual dollar limit - currently about $339 retail value - per physician, says Elizabeth Hogue, a healthcare attorney in Burtonville, Md. That money can be spent on social events, industry attorneys say.

Still, providers like Ann Fabry steer clear of parties or other social gatherings.

“Our sales manager wanted to do a river cruise, which we have done in the past, but not any more,” said Fabry, manager of finance for Home Care Medical in New Berlin, Wis. “If we can’t tie it in with some educational purpose, it’s hard to justify.”

As long as providers stay within the annual dollar limit - and carefully document both expenses and participants - they are safe, says industry attorney Neil Caesar.

“You have to show that the number of attendees multiplied by what you spend is below the cap,” said Caesar, president of the Health Law Center in Greenville, S.C. “It’s a good idea to thank people for recommending you, but better safe than sorry.”

While most providers don’t mind finding small ways to thank physicians for their business, they don’t want to be taken advantage of.

“We get a lot of cases where we try to make contact with referrals and they say ‘Bring in lunch for everyone in the office and we’ll talk to you,’” said Gielniak. “That should be done away with.”

At the end of the day, the industry needs to focus on ways providers can show real value to their referral sources, says Hogue.

“I can see providers doing very intensive training with physicians and their staffs about, for example, CMNs,” she said.