CCRC Referral Incentive Programs OK in Certain Scenarios

CCRC Sales Pitch What’s the correct way to compensate employees and residents for their role in the sales process?  Last month, the Office of Inspector General (OIG) for HHS posted Advisory Opinion 10-05 (AO) that stated that Continuing Care Retirement Community (CCRC) residents and certain employees that successfully referred a candidate to the independent living area of the community could earn rewards.  The opinion on the specifically submitted scenario states that employees that were eligible to earn rewards were not doctors or other health care professionals in capacity to advise directly on health services or medical decisions.  The key question raised by the submission to the OIG is straightforward: would the residents and employees who receive incentives be “arranging for” or “recommending” the purchase or order of items or services payable by a Federal health care program?  According to the report, the arrangement does not implicate the anti-kickback statute.

The specific program offered two types of rewards in the scenario:


1.  Gift Cards for CCRC Tours: Current residents and employees of the Requestor’s CCRCs who recommend their community to a prospective resident will receive a gift card, if they submit the name and contact information of the prospective resident to the CCRC; the CCRC determines that the individual is eligible to enter into a continuing care contract; and the individual tours the community within 90 days. The resident or employee is not required or asked to provide any other promotional services.

2.  Credits/Rewards for Independent Living Referrals: If the prospective resident moves into independent living at the CCRC within 12 months after the tour, the current resident who made the referral will receive a one-time credit of toward his or her monthly CCRC fee. If the referral was made by an employee, the employee will receive a check as part of his or her employment compensation.

For more information, visit Advisory Opinion 10-05 (AO).