It’s the most wonderful time of the year, but if you’re not adhering to gift-giving rules this holiday season, it can be the most legally risky time of the year. Now, I’m not talking about gift-giving between friends—although there should probably be a law against regifting fruitcake, am I right? I’m talkin’ specifically about gifts between patients and their providers.

Let’s be honest: your patients adore you. And why shouldn’t they? You give them the gift of better health with every therapy session, so it’s only natural that many feel compelled to give you a holiday gift to express their appreciation. So, can physical therapists accept gifts from patients? Well, before you accept anything from your patients—or give them a gift of your own—be sure that you take the following guidelines into consideration:

Stalled Out: 5 Reasons Your Patients Are not Progressing (and What to Do About Them) - Regular BannerStalled Out: 5 Reasons Your Patients Are not Progressing (and What to Do About Them) - Small Banner

1. Be generous, but not too generous.

’Tis the season of giving, but the Office of the Inspector General wants to make sure you’re not expecting something in return. You’ve likely heard of the Anti-Kickback Statute, which was developed by the OIG. (If not, you can read all about it here.) In a nutshell, this statute prevents healthcare providers from enticing patients insured under federal health plans to come see them, even if those enticements are considered “gifts.” But, the OIG isn’t a total Scrooge: you’re free to give gifts to your referral sources as long as they meet the following minimum requirements (updated per the 2016 final rule):

  • No more than $15 per gift.
  • No more than $75 in aggregate over the course of a calendar year.

So, you can give gifts to your patients, but the point of the AKS is to ensure healthcare providers aren’t unethically buying referrals.

2. Just say “no” to cash gifts.

Sometimes a little extra cash is the best gift you could receive. But, accepting cash—or a cash equivalent like a gift card—can spark a pretty questionable ethical dilemma. After all, it’s one thing to receive an arrangement of fruit shaped like flowers—but it’s quite another to be handed cold hard cash by someone to whom you’ve referred a patient. That’s where the Stark Law comes in; it’s “all about the benjamins, baby.”

Under the Stark Law, a healthcare provider cannot accept any kind of monetary compensation (cash or gift cards) from another provider if the two providers have a financial relationship. However, a provider can accept non-monetary gifts from another provider if:

  • It does not exceed the per-year aggregate ($398 as of 2017); and
  • It does not take into account the number of patients referred.

3. When in doubt, contact your company’s legal or compliance officers.

The Anti-Kickback Statute and Stark Law are both pieces of Federal legislation, meaning they are applicable in all 50 states. However, every state also has its own version of the Anti-Kickback Statute, which adds a whole other layer to an already very complicated set of regulations. That’s why it’s crucial to keep the law on your side—and on speed-dial. If you’re ever unsure about whether or not a gift falls under an AKS safe harbor or Stark Law exception—or if you need clarity on certain rules or how to apply them—contact your practice’s attorney or compliance officer to determine the best course of action.

4. Scrutinize anything of value that you receive from a vendor.

There’s no such thing as a free lunch. And for the vast majority of vendors, no move is 100% altruistic. After all, their end game is to make money. So, you can see how accepting any kind of gift or donation from a vendor could create a conflict of interest. And if you receive reimbursement from any kind of federal program (e.g., Medicare or Medicaid), there could be legal implications under the AKS. So, before you accept anything free from a vendor, it’s a best practice to first check with your legal or compliance officers.

5. Turn down gifts that are intimate or personal in nature.

So, we all know that accepting overly intimate gifts from patients is a major no-no, right? In addition to being super awkward, overly personal relationships can be detrimental to patient health. Also, it’s important to have boundaries with patients, no matter what kind of relationship you have with them, as this ensures both patient and provider safety.

6. Establish a written gift-giving policy.

In this WebPT Blog article, PT compliance expert Tom Ambury gives some examples of what that policy should include:

  • “Employees may not accept personal gifts such as jewelry or clothing.
  • Employees may accept food gifts as long as they share those gifts with all employees.
  • If a patient wants to give cash, employees should ask the patient to donate the amount to the charity his or her choice. (You also have the option of providing patients with a list of preferred charities.)”

7. Use good judgment when you—or your staff—are unsure of whether a gift meets the criteria for acceptable gifting.

If you’re like me, then you likely have a hard time saying “no” to a heartfelt gift. But sometimes, it’s more important to put your own feelings aside and approach a gift-giving situation from the perspective of patient health. It may also be prudent to have a quick chat with your staff at the start of the holiday season to explain:

  • Why you should turn down gifts if you’re unsure about the giver’s motivations;
  • What to do when a patient, vendor, or referring physician offers you a gift;
  • The ins and outs of your practice’s written gift-giving policy; and
  • Who to contact with any questions.

In the rehab therapy world, holiday presents can be gifts that keep on giving—and not in a good way. So, this holiday season, make a list, check it twice, and confirm which gift-giving practices are naughty—or nice. If you don’t, then the federal government just might come to town.

  • The Ultimate ICD-10 FAQ: Part Deux Image

    articleSep 24, 2015 | 16 min. read

    The Ultimate ICD-10 FAQ: Part Deux

    Just when we thought we’d gotten every ICD-10 question under the sun, we got, well, more questions. Like, a lot more. But, we take that as a good sign, because like a scrappy reporter trying to get to the bottom of a big story, our audience of blog readers and webinar attendees aren’t afraid to ask the tough questions—which means they’re serious about preparing themselves for the changes ahead. And we’re equally serious about providing them with …

  • Denial Management FAQ Image

    articleMay 26, 2017 | 22 min. read

    Denial Management FAQ

    During our denial management webinar , we discussed the difference between rejections and denials, explained how to handle both, and provided a five-step plan for stopping them in their tracks. The webinar concluded with an exhaustive Q&A, and we’ve amassed the most common questions here. Insurance Issues Claim Quandaries Compliance Qualms Documentation Dilemmas Front-Office Frustrations Insurance Issues We’ve had issues with auto insurances denying 97112 (neuromuscular re-education) for non-neuro diagnoses, even in cases when the patient’s medical …

  • ICD-10 Crash Course: Last-Minute Training for PTs, OTs, and SLPs Image

    webinarSep 2, 2015

    ICD-10 Crash Course: Last-Minute Training for PTs, OTs, and SLPs

    It’s officially here: the last month before all HIPAA-eligible professionals must switch to the ICD-10 code set. As the regret of procrastination washes over many of those professionals, they’re scrambling to ready themselves and their practices for the big switch. If you, like so many other rehab therapists, find yourself asking, “ICD-what?” then you’re in dire need of straightforward training—stat! Otherwise, you could leave your practice vulnerable to claim denials after October 1. Join us at 9:00 …

  • The How and Why of an Effective Rehab Therapy Compliance Program Image

    articleAug 9, 2018 | 7 min. read

    The How and Why of an Effective Rehab Therapy Compliance Program

    It’s no secret that the US healthcare industry is heavily regulated—and those regulations are strictly enforced. Take this recent press release from the Department of Justice (DOJ), for example. It explains how the DOJ charged 601 individuals with fraud—the largest healthcare fraud takedown in history. Among them: 71 physicians charged with falsely billing Medicare, Medicaid, and TRICARE in cases involving the prescription and distribution of narcotics. And in New York, 13 individuals were charged with conspiracy for …

  • Give to Get: The How and Why of Patient Loyalty Programs Image

    articleSep 28, 2017 | 8 min. read

    Give to Get: The How and Why of Patient Loyalty Programs

    It’s common knowledge that acquiring new patients is significantly more expensive than keeping existing ones. How much more expensive? According to this Harvard Business Review article —which WebPT’s Kylie McKee cited here —“Depending on which study you believe, and what industry you’re in, acquiring a new customer is anywhere from five to 25 times more expensive than retaining an existing one.” Even if your numbers are on the low end of that range—and that seems unlikely for …

  • The Complete PT Billing FAQ Image

    articleMay 24, 2016 | 25 min. read

    The Complete PT Billing FAQ

    Over the years, WebPT has a hosted a slew of billing webinars and published dozens of billing-related blog posts. And in that time, we’ve received our fair share of tricky questions. Now, in an effort to satisfy your curiosity, we’ve compiled all of our most common brain-busters into one epic FAQ. Don’t see your question? Ask it in the comments below. (And be sure to check out this separate PT billing FAQ we recently put together.) Questions …

  • ICD-10 Open Forum Image

    webinarOct 5, 2015

    ICD-10 Open Forum

    On October 1, the US officially said RIP to ICD-9 and brought ICD-10 to life. For some of you, the transition might’ve been all sugar and spice—a real treat. But for many others, the switch to the new code set might’ve left you feeling overwhelmed, tricked, or even a bit scared. At the very least, you might be haunted by some lingering questions. That’s where we can help. We’ve brewed a cauldron filled to the brim with …

  • Cloudy with a Chance of Reform: 5 Key Healthcare Forecasts for 2017 Image

    webinarJan 5, 2017

    Cloudy with a Chance of Reform: 5 Key Healthcare Forecasts for 2017

    Predicting the weather is tough—just ask any meteorologist who has called for sun on the day of a major downpour. Well, predicting the fate of the US healthcare system isn’t much easier—there’s a lot up in the air, after all. But, even without a healthcare equivalent of Doppler Radar, there are a few key trends that are sure to have a major impact on PTs, OTs, and SLPs in 2017 and beyond. And to keep your practice …

  • Cashing In on Private Pay: The PT's Guide to Going Out-of-Network Image

    webinarJul 27, 2017

    Cashing In on Private Pay: The PT's Guide to Going Out-of-Network

    For many rehab therapists, submitting a claim to a third-party payer feels a lot like pulling the lever on a slot machine. You never know for sure what you’re gonna get—and most of the time, it’s less than you’d hoped for. With seemingly ever-increasing regulations—and constantly shrinking reimbursements—it’s no wonder so many PTs, OTs, and SLPs feel like the financial odds are stacked against them. [video://] As a result, more and more rehab therapy providers are trying …

Achieve greatness in practice with the ultimate EMR for PTs, OTs, and SLPs.