Free Patient Transportation Services

Factors to Consider When the Transportation Safe Harbor is Not Satisfied

Here are some factors pulled from various OIG Advisory Opinions on free patient transportation.  The safe harbors for patient transportation should also be consulted, but these factors may be relevant in cases where not all safe harbor elements can be met.  Some factors identify criteria that makes an arrangement suspect.

• Offering out of state patients free transportation to receive services.
• Compensating drivers of vans or other vehicles on a per patient basis for patients that are brought to the facility.
• Offering free luxury transportation.
• Offering free transportation to the patients of physicians or other referral sources in order to induce them to refer to the facility.
• Free ambulance services without making any determination of financial need.
• Offering free transportation to nursing home residents to a facility,especially for services of questionable necessity.
• The costs of the free transportation must be borne by the facility and should not be passed on to any Federal health care program.
• Higher levels of advertising and marketing of the transportation service will raise more concern.
• Transportation from one provider to another raise a higher level of concern than transportation directly to the facility. In other words, where the transportation is from the place of business of a potential referral source (i.e. physician or other health care provider) the fraud and abuse risk is higher.
• Whether there are other methods of affordable transportation in the area. If affordable transportation options are not readily available, the arrangement will raise less concern.
• Whether the services are offered and/or marketed outside of the facilities normal service area. The OIG looks with disfavor on “leap-frog” arrangements that induce patients to bypass other closer providers due to the free or low cost transportation arrangement.
• The OIG also raised general concerns about the provider who uses free transportation to gain access to patients, potentially for unnecessary or questionable services.