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AO 16-03
Posted March 18, 2016Regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies.
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AO 16-02
Posted March 1, 2016regarding a state academic medical center that in certain circumstances offers pregnant women: (1) transportation aid to and from the campus hospital for delivery; and (2) short-term lodging near the campus hospital.
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AO 16-01
Posted January 25, 2016Regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby [names redacted] (the "Requestors") 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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AO 08-17
Updated January 20, 2016Regarding a proposal by a nonprofit, tax-exempt, charitable organization to provide financial assistance to cover cost-sharing obligations associated with outpatient drug treatment owed by financially needy Medicare or Medicaid patients with a certain disease state.
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AO 10-06
Updated January 20, 2016Concerning a patient assistance program that assists underinsured patients with their prescription drug co-payment obligations.
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AO 04-15
Updated January 6, 2016Concerning grants provided by a nonprofit, charitable organization to financially-needy patients suffering from specific chronic or life-threatening diseases to defray the costs of prescription drug therapies.
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AO 15-16
Posted January 2, 2016Regarding a nonprofit, tax-exempt, charitable organization's proposal to provide assistance with out-of-pocket expenses for outpatient prescription drugs to financially needy insured patients, including, but not limited to, Medicare and Medicaid beneficiaries.
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AO 15-17
Posted January 2, 2016Regarding a non-profit, tax-exempt, charitable organization's proposal to provide financial assistance with copayment obligations, health insurance premiums, and insurance deductibles to patients, including Medicare and Medicaid beneficiaries, receiving treatment for [disease state redacted].
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AO 07-06
Updated December 29, 2015Regarding an arrangement by a nonprofit, tax-exempt, charitable organization to subsidize cost-sharing and premium obligations owed by financially needy Medicare or Medicaid patients with certain chronic diseases.
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AO 11-05
Updated December 29, 2015Regarding a proposal by a tax-exempt charitable organization to provide financial assistance with cost-sharing obligations for certain genetic tests to financially needy individuals, including but not limited to Medicare and Medicaid beneficiaries, and an existing practice of providing vouchers for free genetic tests to individuals who are uninsured or whose insurance does not cover genetic tests.
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AO 15-15
Posted December 29, 2015Regarding a proposal for a hospital to bill a radiology group for transcription of the radiology group's reports for individuals who are not hospital patients, but rather patients of a third-party clinic that provides the technical component of the radiology exams.
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AO 06-13
Updated December 16, 2015Regarding a proposal by a nonprofit, tax-exempt, charitable organization to provide financially needy persons who have certain diseases with grants to defray the costs of premiums and cost-sharing obligations under Medicare Part B, Medicare Part D, Medicare Supplementary Health Insurance, and Medicare Advantage.
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AO 07-11
Updated December 7, 2015Regarding a proposal by a nonprofit, tax-exempt, charitable organization to establish a foundation to provide financially needy cancer patients with grants to defray their out-of-pocket treatment costs.
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AO 06-10
Updated November 2, 2015Regarding an arrangement in which a nonprofit, tax-exempt, charitable organization provides certain therapy management services and assistance with Medicare cost-sharing obligations to financially needy Medicare beneficiaries undergoing medical treatment for certain diseases.
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AO 07-18
Updated November 2, 2015Regarding an existing arrangement by a nonprofit, tax-exempt, charitable organization to subsidize cost sharing, and its proposal to subsidize premium obligations, associated with outpatient drug treatment owed by financially needy Medicare or Medicaid patients with certain chronic diseases.
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AO 15-13
Posted October 21, 2015Regarding a plan to offer free van shuttle service to certain medical facilities in an integrated health system.
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AO 15-12
Posted August 13, 2015Regarding a home health provider's policy to offer free introductory visits to patients who have chosen it as their home health provider.
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AO 15-11
Posted August 12, 2015Regarding a program to provide a drug for free for a limited time to patients who experience a delay in the insurance approval process.
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AO 15-10
Posted July 28, 2015Regarding a hospital system's proposal to lease non-clinician employees and to provide operational and management services to a related psychiatric hospital for an amount equal to the hospital system's fully loaded costs.
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AO 15-09
Posted July 23, 2015Regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies.