Alerts1.13.26
HHS-OIG Issues Unfavorable Advisory Opinion on Sign-On Bonuses for Home Care Agency Attendants
Highlights
- The U.S. Department of Health and Human Services-Office of Inspector General (HHS-OIG) released an unfavorable opinion regarding a home care agency's sign-on bonus program for attendants, finding it posed sufficient risk of fraud and abuse under the Anti-Kickback Statute and Beneficiary Inducements CMP to warrant potential sanctions.
- The proposed arrangement failed to satisfy the employee safe harbor because of an "inextricable link" between attendant employment and client referrals, where family member attendants would simultaneously serve as both employees and decision-makers selecting the agency on behalf of their Medicaid beneficiary relatives eligible for services (clients).
- HHS-OIG distinguished this arrangement from typical employment sign-on bonuses because the attendants' employment would be based solely on providing services to their own family members, making the recruitment materials effectively operate as advertisements for new clients rather than simply employee recruitment tools.
The HHS-OIG recently released Advisory Opinion No. 25-12, an unfavorable opinion regarding the federal Anti-Kickback Statute (AKS) and civil monetary penalty laws (CMP) against beneficiary inducements as applied to a proposed sign-on bonus arrangement, offered by a home care agency, to prospective attendant employees who would primarily be family members of clients and who would serve as the decision-makers selecting the agency on behalf of those family members for the provision of in-home support services reimbursable by the state Medicaid program.
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