Q&A: Disclosing financial relationships

April 18, 2017
Medicare Web

Q. Should hospitals refer patients to postacute care providers with which they have a financial relationship?

A. The mere existence of a financial relationship between a hospital and a postacute care provider is not by itself indicative of potential inappropriate action. A hospital’s referral of a patient to a postacute care provider in which it has a financial interest would not in itself constitute fraud or abuse. Nonetheless, some discharge planners express concern that such referrals may be perceived as abuse if a substantial percentage of their patients receive them. However, discharge planners are responsible for qualifying agencies that will meet patient needs and for giving patients a choice of qualified agencies. If the only qualified agency has a financial relationship with the hospital, discharge planners must exercise professional judgment and feel confident in their decision when making such a referral.

For more information, see Discharge Planning Guide: Tools for Compliance, Fourth Edition.

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