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Originally posted by Replaced_Texan
Really? There's a $300 limit per year under Stark for de-minimus gifts at 42 C.F.R. section 411.357 (k), but I'll be damned if I can find a de-minimus exception in the anti-kickback law.
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So are you saying that a $5 cafeteria lunch meets the definition of a kick-back? If so, every hospital in the US is guilty of these kick-backs. I don't know of any hospitals that don't have doctor's lounges in which they provide free food for the doctors except for maybe county hospitals on tight government funded budgets. It is a common practice for hospitals to do this. If you have any friends who are doctors, ask them.
And I don't think it qualifies as a kickback unless there is some sort of quid pro quo. Perhaps I am wrong and if you give someone something for free and ask for and expect nothing back, that is a kickback.
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Originally posted by Replaced_Texan
It's not clear by your posts whether you read public health literature, so I guess we're even.
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What specifically in my posts makes you think I don't read public health literature?
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Originally posted by Replaced_Texan
I've been watching medical savings accounts since they were introduced (in a very limited way) in HIPAA. I know a few people who've taken advantage of them, and they get mixed reviews. One couple I know ended up swapping out the MSA for a high-deductible insurance policy through a professional organization. The problem was that ultimately, the consumer ended up paying astronomically high premiums for individual insurance, probably because the insurance pool was so small. I agree that they're promising, but the law needs to be expanded beyond self-employed individuals to see how well they will end up working.
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The problem is indeed that they have been limited to self-employed individuals. There were a few employer-based plans that used the MSA approach and were studied by economists and had good results.
The main difficulty in MSAs is structuring the incentives properly and if it is an employer-based plan, all the EEOC regulations. Sometimes it is not clear cut what is discretionary healthcare spending and what is not and if it is considered discretionary and the employee has to pay more for this, would the EEOC find some sort of discrimination is occuring.
