Section: 4.10
Issued: 12.31.2005
Updated: 03.20.2023
Purpose
The purpose of this policy is to delineate AHRC NYC’s stance that people supported should never be offered any inducement including payments or waivers of co-payments to receive services or supports from AHRC NYC.
Policy Overview
AHRC NYC and its employees must not offer or transfer remuneration to any person receiving supports who is eligible for benefits under federal or state health care programs (including Medicare or Medicaid) in order to influence that person to receive any item or service for which payment may be made by a federal or staff health care program from a particular provider, practitioner, or supplier.
Scope
This Policy and Procedure applies to all employees and representatives of AHRC NYC.
Procedure
AHRC NYC and its employees must not offer or provide any gift, hospitality or entertainment worth more than $10 per item or $50 per year to any Medicaid beneficiary. Examples of permissible items include pens, T-shirts, water bottles, etc., valued at $10 or less per item or $50 per year as long as such items are not offered or provided to influence health care decisions by a person supported, family member, or responsible party.
AHRC NYC and its employees must not offer waivers of coinsurance or deductible amounts as part of any advertisement or solicitation.
AHRC NYC and its employees must not routinely waive coinsurance or deductible amounts and must waive such amounts only after determining in good faith and documenting that the beneficiary is in financial need, or after making reasonable efforts to collect the cost-sharing amounts from the beneficiary.