Comparison Chart of Anti-Kickback Safe Harbors and Stark Exceptions -- Local Transportation
Local Transportation – Current as of March 2021
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Stark |
Anti-Kickback |
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Free or discounted local transportation made available by an eligible entity to Federal health care program beneficiaries if all the following conditions are met: The availability of the free or discounted local transportation services - (A) Is set forth in a policy, which the eligible entity applies uniformly and consistently; and The free or discounted local transportation services are not air, luxury, or ambulance-level transportation; The eligible entity does not publicly market or advertise the free or discounted local transportation services, no marketing of health care items and services occurs during the course of the transportation or at any time by drivers who provide the transportation, and drivers or others arranging for the transportation are not paid on a per-beneficiary-transported basis; The eligible entity makes the free or discounted transportation available only: (A) To an individual who is: (1) An established patient (as defined in this paragraph (bb)) of the eligible entity that is providing the free or discounted transportation, if the eligible entity is a provider or supplier of health care services; and (B) Within 25 miles of the health care provider or supplier to or from which the patient would be transported, or within 75 miles if the patient resides in a rural area, as defined in this paragraph (bb) except that, if the patient is discharged from an inpatient facility following inpatient admission or released from a hospital after being placed in observation status for at least 24 hours and transported to the patient's residence, or another residence of the patient's choice, the mileage limits in this safe harbor do not apply; and The eligible entity that makes the transportation available bears the costs of the free or discounted local transportation services and does not shift the burden of these costs onto any Federal health care program, other payers, or individuals Free or discounted transportation in the form a “shuttle service” if all of the following conditions are met: The shuttle service is not air, luxury, or ambulance-level transportation; The shuttle service is not marketed or advertised (other than posting necessary route and schedule details), no marketing of health care items and services occurs during the course of the transportation or at any time by drivers who provide the transportation, and drivers or others arranging for the transportation are not paid on a per-beneficiary-transported basis; The eligible entity makes the shuttle service available only within the eligible entity's local area, meaning there are no more than 25 miles from any stop on the route to any stop at a location where health care items or services are provided, except that if a stop on the route is in a rural area, the distance may be up to 75 miles between that stop and any providers or suppliers on the route; The eligible entity that makes the shuttle service available bears the costs of the free or discounted shuttle services and does not shift the burden of these costs onto any Federal health care program, other payers, or individuals. The following definitions apply: An eligible entity is any individual or entity, except for individuals or entities (or family members or others acting on their behalf) that primarily supply health care items. An established patient is a person who has selected and initiated contact to schedule an appointment with a provider or supplier, or who previously has attended an appointment with the provider or supplier. A shuttle service is a vehicle that runs on a set route, on a set schedule. A rural area is an area that is not an urban area. An urban area is: (A) A Metropolitan Statistical Area (MSA) or New England County Metropolitan Area (NECMA), as defined by the Executive Office of Management and Budget; or |