No VIP Treatment: ACOs Should Not Get Waiver Protection from the Prohibition on Beneficiary Inducement
ABSTRACT
Accountable Care Organizations (“ACOs”) require flexibility from the existing healthcare fraud and abuse framework. This flexibility includes a waiver from the prohibition on beneficiary inducement, affording ACOs significant freedoms to employ inducements in ways that other healthcare delivery models cannot. This waiver was intended to give ACOs an additional mechanism to retain patients and boost participation in disease management and compliance programs. Improving patient compliance with healthcare directives is a crucial component of healthcare reform but at what cost? This Note argues that ACOs should not be given a waiver from the prohibition on beneficiary inducement as the risks of distorting patient decisionmaking outweigh the benefits of affording ACOs more freedom. This Note proposes that ACOs operate within the existing enumerated exceptions of the prohibition and offers supplemental strategies to address patient attrition and compliance within ACOs.
AUTHOR
J.D. Candidate, 2017, Vanderbilt University Law School; M.P.H., 2013, The Dartmouth Institute, Geisel School of Medicine; B.A., 2011, Boston University.