[co-author: Jason Betke - Law Clerk]

The Office of Inspector General (OIG) recently issued another advisory opinion on free patient transportation (OIG Adv. Op. No. 15-13, dated October 21, 2015). In the opinion, the OIG addresses whether providing patients a free shuttle service between medical facilities operated by an integrated health system (the System) would be prohibited remuneration to beneficiaries under the Anti-Kickback Statute. Because the free shuttle service posed minimal risk of fraud and abuse, and because it improved access to care, the OIG concluded that it would not impose sanctions against the System.

The System requesting the Advisory Opinion is in a rural area without public transportation. The System’s free shuttle provides transportation between the System’s facilities including its medical center, a clinic, two community hospitals, and an ambulatory surgery center.

The OIG’s analysis relies on the following factors to conclude that the System’s free shuttle service poses minimal fraudulent abuse risk:

• The shuttle service is available to all, without regard to diagnosis, condition, treatment or type of insurance coverage and is not based on volume or value of Medicare or Medicaid services.
• Patients may utilize the shuttle service regardless of ability to pay for the System’s services.
• The compensation of shuttle drivers does not include a per-person or per-patient-transported formula.
• The System bears the costs for providing the transportation, and it represented that it would not shift the costs to the Medicare or Medicaid programs, other payers, or individuals.
• The shuttle service does not include luxury types of transportation.
• There would not be any marketing of health care services or items while transporting patients. The OIG did note the shuttles would include signage designating the vans as property of the System but determined the signage was for safety and unlikely to influence passengers to purchase services from the System.
• The transportation is provided along local service routes within the System’s primary service area.
• The shuttle service would not be advertised to the general public or listed on the System’s website. Notice of the shuttle service could be posted in patient waiting areas.

The Advisory Opinion applies criteria similar to the proposed local transportation safe harbor, published in October 2014, but not yet adopted.