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Health Law Alert

2016: Issue 7

OIG Approves Another Medigap/Preferred Hospital Network in Advisory Opinion 16-04

In Advisory Opinion 16-04, the OIG reviewed the contract between a Medigap insurer and a preferred hospital network for discounts on Medicare inpatient deductibles, and determined that the arrangement posed a low risk of fraud and abuse. Meredith Larson briefly reviews the arrangement and the OIG’s assessment under the anti-kickback statute and the civil monetary penalty prohibition against beneficiary inducement.