The debate over providing transportation to patients is nothing new. Hospitals, doctors and other providers have long struggled with whether they can provide free or discounted taxis, shuttles, metro cards or other transportation means to patients to come to appointments and receive care. On one hand, there is evidence that without reliable transportation options, patients are more likely to miss preventative, primary care appointments, increasing the risk of more costly and unnecessary medical services down the road. On the other hand, certain federal laws like the Anti-Kickback Statute (AKS) and Civil Monetary Penalty (CMP) law have given providers serious concerns that such transportation services might be considered an illegal “kickback” to gain patients, or an illegal inducement to receive care.
So what is new?
(1) After years of debating the issue, in early 2017, the Office of Inspector General (OIG) announced a safe harbor that protects a health care provider or other eligible entity (i.e., any individual or entity, except those who primarily supply health care items) from AKS and CMP penalties if it provides free or discounted local transportation to Medicare patients and other federal health care program beneficiaries, so long as all of a number of conditions are met.
(2) In early 2018, the two most popular rideshare apps—Uber and Lyft—began partnering with healthcare providers to offer transportation options to patients. Specifically, Uber launched Uber Health that will offer a transportation platform for providers to schedule rides for their patients and caregivers who need help getting to and from medical appointments. Meanwhile, Allscripts is joining forces with Lyft to incorporate patient transportation directly into Allscripts Sunrise EHR so that when a patient’s transportation needs are noted in his or her medical record, a Lyft is automatically scheduled for that patient.
What does this mean for providers?
Providers are now able to leverage the convenience of these ubiquitous apps to ensure better care for their patients. However, care should be taken to ensure that these patient rideshares are done in a legally compliant way. Primarily, providers should adhere as closely as possible to the OIG’s safe harbor regulations which require, among other things, that there be a written policy in place which restricts how transportation services are used and advertised. Additionally, since drivers will have access to individually identifiable and/or protected health information, providers must have appropriate business associate agreements in place to comply with the Health Insurance Portability and Accountability Act. Providers should consult with legal counsel well-versed in these laws before implementing a patient rideshare program.