OIG Updates Threshold for Nominal Value Gifts

Just as the civil monetary penalties have gotten an update to adjust for inflation (see “Civil Monetary Penalties Rules Updated” Lab & Pathology Insider, Jan. 3, 2017), so too have the thresholds for nominal value gifts to beneficiaries that can escape sanctions.

The civil monetary penalties law prohibits “remuneration” to federal program beneficiaries such as waivers of copayments or deductibles or providing any item or service for free or less than fair market value. But there are exceptions. One exception permits inexpensive gifts of “nominal value.” To avoid any confusion about what the government will consider to be inexpensive or of nominal value, the OIG has set thresholds.

Nominal value was previously interpreted to be no greater than $10 per item or $50 in the aggregate annually, per patient. Now, the OIG is updating those figures in a December policy statement setting nominal value as a retail value up to $15.00 per item or $75 in the aggregate per patient per year. Note that such gifts can’t be cash or cash equivalents. The OIG promised to continue monitoring the issue and make future adjustments “if appropriate.”

For more information about gifts to beneficiaries, see the OIG’s Special Advisory Bulletin, “Offering Gifts and Other Inducements to Beneficiaries,” August 2002.