Law from the Department of Health and Human Services

Office of Inspector General

IT IS UNLAWFUL TO ROUTINELY WAIVE CO-PAYMENTS, DEDUCTIBLES, COINSURANCES OR OTHER PATIENT RESPONSIBILITY PAYMENTS.

This includes services deemed as “professional courtesy” and “TWIPS-Take what insurance pays”.  Absent financial hardship, a "good faith effort" must be made to collect all deductibles and co-payments due and owed. 

Failure to comply makes you in violation of the

(1) Federal False Claims Act

(2) Federal Anti-Kickback Statute

(3) Federal and State Insurance Fraud Laws

and may result in civil money penalties (CMP) in accordance with the new provision section 1128 A(a)(5) of the Health Insurance Portability and Accountability Act of 1996 [section 231(h) of HIPAA].

For any questions please contact:

Office of Inspector General

Department of Health and Human Services:

By Phone: 202 619-1343
By Fax: 202 260-8512
By E-Mail: paffairs@oig.hhs.gov
By Mail: Office of Inspector General

Office of Public Affairs
Department of Health and Human Services
Room 5541 Cohen Building
330 Independence Avenue, S.W.
Washington, D.C. 20201

Joel Schaer

Office of Counsel to the Inspector General

(202) 619-0089

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