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AO 06-04
Updated November 28, 2017Regarding 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.
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AO 17-06
Posted November 16, 2017Regarding 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.
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AO 17-05
Posted September 7, 2017Regarding 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.
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AO 17-04
Posted August 31, 2017Regarding 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.
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AO 17-03
Posted August 25, 2017Regarding a pharmaceutical manufacturer's proposal to replace products that require specialized handling that could not be administered to patients for certain reasons, at no additional charge to the purchaser.
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AO 17-02
Posted July 7, 2017Regarding 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.
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AO 02-01
Updated March 10, 2017Regarding 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.
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AO 17-01
Posted March 10, 2017Regarding a hospital system's proposal to provide free or reduced-cost lodging and meals to certain financially needy patients.
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AO 16-13
Posted December 20, 2016Regarding: (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.
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AO 16-12
Posted December 5, 2016Regarding a laboratory's proposal to provide services consisting of the labeling of test tubes and specimen collection containers at no cost to dialysis facilities.
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AO 16-11
Posted November 3, 2016Regarding 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.
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AO 16-10
Posted October 11, 2016Regarding a local health care district's proposal to cooperate with another district to jointly fund the cost of a transportation coordinator to educate patients about local transportation options and subsidize certain forms of transportation for patients with financial need.
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AO 16-09
Posted September 23, 2016Regarding a proposal to install a computerized point-of-care vaccine storage and dispensing system in physicians' offices for the physicians' use.
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AO 16-08
Posted July 27, 2016Regarding an arrangement in which a hospice would make a supplemental payment to the nursing facilities in which the hospice's dually eligible patients reside when the nursing facilities-instead of the hospice-receive payment for their patients' room and board expenses.
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AO 10-12
Updated July 22, 2016Concerning a nonprofit, tax-exempt, charitable organization's proposal to provide financially-needy patients with grants to defray their cost-sharing obligations for drugs and/or devices to treat brain tumors and conditions incident to brain tumors.
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AO 16-07
Posted June 27, 2016Regarding a savings card program under which individuals who have prescription drug coverage under Medicare Part D receive discounts on a drug that is statutorily excluded from coverage.
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AO 10-07
Updated May 12, 2016Regarding a proposal by a nonprofit, tax-exempt, charitable organization to provide assistance with cost-sharing obligations to financially needy individuals, including Medicare and Medicaid beneficiaries, diagnosed with Multiple Sclerosis, cancer, or rheumatoid arthritis.
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AO 16-06
Posted May 9, 2016Regarding your proposal for an entity to purchase the remaining five percent ownership interest in a group purchasing organization.
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AO 16-05
Posted May 3, 2016Regarding the use of a “preferred hospital” network as part of Medicare Supplemental Health Insurance (“Medigap”) policies, whereby [name redacted] 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.
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AO 16-04
Posted April 19, 2016Regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby three insurance companies would indirectly contract 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.
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