Moreover, the hospital certified to the OIG that the costs of the transportation are not claimed directly or indirectly on any Federal health care program cost report. The transportation service are also not marketed or advertised. Hospital staff may recommend potentially eligible patients to department directors who determine if eligibility requirements are met and, if so, refer the patients to the Patient Transportation Department. Patients are then prioritized by medical need, travel distance, the number of other patients needing transportation, and the time of treatment. The hospital certified to the OIG that none of the referrals or decisions by hospital staff, department directors or the Patient Transportation Department are based upon the patient's ability to pay for the medical services or the existence, nature or extent of the patient's insurance coverage.
Remuneration includes transfer of items or services for free or for other than fair market value.
Here, the frequency and cost of the transportation services provided would exceed the nominal value limits and thus arguably be remuneration in violation of the CMP Statute. The services are not advertised and are only available to persons who are already referred or being treated at the hospital. The services are only provided following an individualized determination of need. The services are available to all who qualify for multiple treatments, subject to available resources, rather than being targeted to profitable treatments or populations. The costs of the services are not borne directly or indirectly by Federal health care programs.