The December alert focuses on two areas: payments from MA organizations to healthcare professionals linked to MA plan marketing and enrollment, and payments from HCPs to agents or brokers involved in MA plan enrollments.
These arrangements may violate federal anti-kickback statutes by incentivizing the steering of Medicare enrollees toward plans or providers based on payments rather than suitability. OIG is concerned about unfair competition and potential harm to beneficiaries, and MA plans should evaluate their existing partnerships and payment structures for compliance to reduce legal and reputational risks.
At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 17–19 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.
