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Browse Advisory Opinions

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Showing 41–60 of 174 advisory opinions
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  • AO 20-05

    Regarding a pharmaceutical manufacturer's proposal to provide cost-sharing assistance directly to Medicare beneficiaries who are prescribed either of two formulations of its drug.

    Posted Sept. 22, 2020
  • AO 19-04

    Regarding a technology company's proposal to make visible to Federal health care program beneficiaries: (i) its online healthcare directory for searching and booking medical appointments, where healthcare professionals pay, or would pay, per-click or per-booking fees to be listed in the directory; and (ii) sponsored advertisements on its online healthcare directory and third-party websites, where healthcare professionals pay, or would pay, per-impression or per-click fees for such sponsored advertisements (the "Proposed Arrangement").

    Posted Sept. 9, 2019
  • AO 19-03

    Regarding a program offered by a medical center that provides free, in-home follow-up care to eligible individuals with congestive heart failure (the "Current Arrangement") and the proposed expansion of this program to include certain individuals with chronic obstructive pulmonary disease.

    Posted March 6, 2019
  • AO 18-12

    Regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract indirectly with hospitals for discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay (the "Proposed Arrangement").

    Posted Oct. 28, 2018
  • AO 18-10

    Regarding a surgical device and wound care product manufacturer's proposal to offer hospital customers a warranty program covering a suite of three products.

    Posted Sept. 16, 2018
  • AO 18-09

    Regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract indirectly with hospitals for discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay.

    Posted Aug. 20, 2018
  • AO 18-07

    Regarding a proposal from a group purchasing organization ("GPO") to serve as a purchasing agent on behalf of certain GPO-affiliated health care facilities on the same terms and conditions that apply to its unaffiliated members.

    Posted Aug. 5, 2018
  • AO 18-06

    Regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract indirectly with hospitals for discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay.

    Posted July 17, 2018
  • AO 18-05

    Regarding an arrangement under which a hospital has established a caregiver center that provides or arranges for free or reduced-cost support services to caregivers in the local community.

    Posted June 24, 2018
  • AO 18-04

    Regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby insurance companies would contract indirectly with hospitals for discounts on the otherwise-applicable Medicare inpatient deductibles for their policyholders and, in turn, would provide a premium credit of $100 to policyholders who use a network hospital for an inpatient stay.

    Posted June 13, 2018
  • AO 18-01

    Regarding the effect of your exclusion from Medicare, Medicaid, and all other Federal health care programs.

    Posted Feb. 26, 2018
  • AO 17-08

    Regarding your proposal to develop a state-wide network of nursing facilities that would provide discounts on the daily rates they charge to private long-term care insurers and the insurers' policyholders.

    Posted Dec. 14, 2017
  • AO 17-07

    Regarding a pharmaceutical manufacturer's proposal to collaborate with a trade association, a Medicare Advantage plan, and a hospital system to implement, fund, and evaluate a pilot program to provide the Medicare Advantage plan pharmacists who conduct medication therapy management services with new technology that would permit real-time electronic access to patient discharge information.

    Posted Dec. 10, 2017
  • AO 06-04

    Regarding a proposal by a nonprofit, tax-exempt, charitable corporation to provide financially needy Medicare beneficiaries with assistance with premiums and cost-sharing obligations under Medicare Part B, Medicare Part D, Medigap, and Medicare Advantage.

    Updated Nov. 27, 2017
  • AO 17-06

    Regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would indirectly contract with hospitals for discounts on the otherwise applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 to policyholders who use a network hospital for an inpatient stay.

    Posted Nov. 15, 2017
  • AO 17-05

    Regarding a retail pharmacy chain's proposal to allow Federal health care program beneficiaries to participate in a paid membership program that includes discounts on certain prescriptions and clinic services.

    Posted Sept. 6, 2017
  • AO 17-04

    Regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby insurance companies indirectly contract with hospitals for discounts on the otherwise-applicable Medicare inpatient deductibles for their policyholders and, in turn, provide a premium credit of $100 to policyholders who use a network hospital for an inpatient stay.

    Posted Aug. 30, 2017
  • AO 17-02

    Regarding a hospital outpatient facility's proposal to reduce or waive, on a non-routine, unadvertised basis, cost-sharing amounts owed by financially needy Medicare beneficiaries for items and services furnished in connection with a clinical research study.

    Posted July 6, 2017
  • AO 02-01

    Regarding a proposed arrangement in which grants would be provided by a non-profit, charitable organization to financially needy Medicare beneficiaries in order to subsidize their costs of medical care.

    Updated March 9, 2017
  • AO 16-13

    Regarding: (i) a proposal to waive cost-sharing obligations incurred by individuals for health care services required for participation in a government-funded clinical research study (the "Proposed Arrangement"); and (ii) the payment of a stipend to study participants for the time and effort required to participate in study visits.

    Posted Dec. 19, 2016