CMS Pub. 100-08, ch. 4, § 4.16.1.1

This section applies to UPICs.

Certain marketing or solicitation practices could be in violation of the Medicare anti-kickback statute, 42 U.S.C. 1320a-7b(b). All marketing practices shall comply with the

Medicare anti-kickback statute and with the Office of the Inspector General's (OIG’s)

Compliance Program Guidance for the DMEPOS industry.

Marketing practices may influence Medicare beneficiaries who use medical supplies,

such as blood glucose strips, on a repeated basis. Beneficiaries are advised to report any

instances of fraudulent or abusive practices, such as misleading advertising and

excessive or non-requested deliveries of test strips, to their durable medical equipment

MACs.

Advertising incentives that indicate or imply a routine waiver of coinsurance or

deductibles could be in violation of 42 U.S.C. 1320a-7b(b). Routine waivers of

coinsurance or deductibles are unlawful because they could result in--1) false claims; 2)

violation of the anti-kickback statute; and/or 3) excessive utilization of items and

services paid for by Medicare.

In addition, 42 U.S.C. 1320a -7a(a) (5) prohibits a person from offering or transferring

remuneration. Remuneration is a waiver of coinsurance and deductible amounts, with

exceptions for certain financial hardship waivers that are not prohibited.

Suppliers should seek legal counsel if they have any questions or concerns regarding

waivers of deductibles and/or coinsurance or the propriety of marketing or advertising

material.

Any supplier that routinely waives co-payments or deductibles can be criminally

prosecuted and excluded from participating in Federal health care programs.