by Ray Foxworth, D.C., FICC •
President & Founder, ChiroHealthUSA •
In 2021, the Office of Inspector General (OIG) budgeted $329 million for oversight of the Medicare and Medicaid programs, including Health Care Fraud and Abuse Control (HCFAC) Program activities and law enforcement activities coordinated with HHS and the Department of Justice (DOJ). In addition, they continued to invest money in modernizing and updating their information technology. These efforts have assisted investigative analysts in sifting through data about questionable billing practices in just hours instead of weeks. It is anticipated that the FY2022 budget will reflect additional money budgeted to continue expanding and updating the information technology system. (OIG, 2021)
We reported in 2020 that the OIG is utilizing the impact of social media to educate patients on how to report pricing and discount concerns. With regular videos posted to social media and FB live events during which patients can #AskanInvestigator, the OIG uses every available channel to educate patients on identifying and reporting even their smallest concerns. (CHUSA, 2020) The rules and regulations are often conflicting and confusing, making it difficult for doctors and their teams to know which discounts to patients are good, bad, and illegal. As part of our commitment to protect and educate the profession, ChiroHealthUSA has launched the Discount Challenge 2.0. You have 5 minutes to review ten scenarios and identify which discount practices are good, bad, or illegal. The Discount Challenge will last from now through October 31, 2022. In December, one lucky person will be the recipient of $15,024. Why $15,024?
The penalty amount for Medicare inducements was increased to $15,024. That is not per patient or per provider, but per violation, which can add up to hundreds of thousands of dollars in fines very quickly. (Office of Inspector General, 2016) What is the difference? A “Good” discount is compliant and may be applied to any patient, no matter who pays the bill (Legally Defensible). A “Bad” discount is one that your state may allow, but not the feds or insurance carriers (Subject to Interpretation). Another example of a bad discount is one that is so low, you may not be covering the cost of delivering the care. (If you would like to know the cost of delivering care down to a single visit, click here.) An “Illegal” discount will likely land you in hot water if your office is audited (Not Legally Defensible).
Whether you are an expert on discounting in your practice or not, test your knowledge in just 5 minutes by answering just 10 questions. Every correct answer gets you an entry in the challenge to win $15,024. Once you’ve answered a challenge question correctly, you will receive one prize entry for that question. You can receive a maximum of 10 entries meaning that you have answered all ten questions correctly. If you miss one or two, you’ll see information on what the correct answer should have been with links to sources where you can learn more. You may take the challenge as many times as you like until you answer all ten questions correctly. For full official rules and prize disclosures, click here. Test Your Knowledge. Have Some Fun. Enter to Win. Take the Discount Challenge 2.0!
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Why is the Discount Challenge prize amount $15,024? Because that is the average “per-occurrence” fine for Medicare inducements. That’s not $15,024 per patient, that’s not per provider, that’s PER VISIT. Stinks, doesn’t it? To us, the prize amount is worth the investment if we can help our profession better understand proper discounting.