The OIG Addresses Free Patient Transportation Issues

The OIG issued an advisory opinion upon the request of a hospital system who had asked whether it could provide free transportation to persons who had limited access to public transportation to access the hospital’s facilities. The hospital system offered that the town had inadequate and infrequent public transportation services which would act as a barrier to healthcare for local residents. The hospital system offered the following facts for consideration:

• The transportation vans would run a fixed circuit between the hospital’s various medical facilities and to the center of the local town between 8 a.m. and 6 p.m. daily;

• The transportation service would not be marketed at all; except: the availability of the service would be communicated to persons who were already patients of the hospital system; patient waiting areas within the hospital system would contain signs regarding the transportation option; hospital personnel may communicate the availability of the transport service to patients; and the vans would have signage indicating they were hospital vans;

• The van service would not engage in any marketing towards persons being transported;

• The vans would not be equipped or operated as ambulances;

• The vans would not be equipped with medical supplies or personnel;

• The operators of the vans would be bona fide employees of the hospital system and would not be paid based on the volume of patients transported; and

• Individuals would be allowed to use the van service regardless of they had health insurance or were able to pay for healthcare items or services.

(When the OIG issues advisory opinions such as the one detailed above, they are based on a specific set of facts and applying those facts to relevant law. Reliance on an advisory opinion when a health care provider has deviated from the fact set established in the advisory opinion may not necessarily indicate compliance with the law.)

The OIG considered the facts in light of the restrictions put in place by the Federal Anti-Kickback Statute (“AKS”). The AKS makes it a criminal offense to knowingly offer, pay, solicit or receive anything of value induce or reward referrals of healthcare items or services reimbursable by a Federal healthcare program, like Medicare or Medicaid. If even one purpose of an arrangement is intended to obtain money for patient referrals, the AKS is implicated.

The OIG considered the facts set forth above and concluded that they could potentially implicate the AKS because the van service might be offered to induce patients who are insured by Federal healthcare programs to obtain healthcare items or services. However, the OIG ultimately concluded that, based on the facts certified by the hospital, the risks of such arrangement were minimal and would likely not result in criminal prosecution.

The scenario offered by the hospital system differs from the scenario that we are normally asked to analyze in three key ways:

1. The hospital system does not offer patient pick-up from home, it picks up all patients from a central location on a set schedule;

2. The hospital system does not market that it provides free transportation; and

3. The hospital system employs the drivers and pays them flat salaries instead of “per ride”.

Deviation in any one of these areas might further implicate the laws and will likely increase the healthcare provider’s risk for criminal prosecution.

Demystifying the Definition of “Certified Translation”

Have you been asked to provide a “certified translation?”

If so, there are many translation agencies which will sell you the service, usually for an inflated fee for the “certification.” But is this worth what they are charging?

The answer is, almost always, no.

The translation industry has virtually no regulation. There are various associations such as the ITI (Institute of Translation and Interpreting) which seek to represent translators, though in reality, they only represent those who are willing to pay their annual membership fees, some of which can be very expensive.

Due to the lack of regulation, there are various companies which will make bold claims without any substance, safe in the knowledge that they will likely get away with it. Certified and notarised translations are an excellent example.

Usually, the consumer will receive a translation (the quality of which may be terrible) which has been stamped, possibly with the emblem of an organisation few will have heard of. The hope is that, whoever has requested the translation be certified is duped into believing that the stamp authenticates the work as accurate to a high standard. The truth is that the stamp means very little because the translator has usually not been vetted before receiving it. There are many occasions when these translations are simply rejected for invalid certification.

The English Courts have a strict procedure for certification. If a witness cannot speak English, he or she must provide a statement in their native language and that statement must be certified by an individual who is able to administer oaths and take affidavits. The only people allowed to do so under the Civil Procedure Rules are listed at

You Cannot Regulate Your Way to Air Superiority – But Tell The FAA That

Over regulation is killing our economy and hurting jobs in the US, but how can we get our government to knock this off? Some say we need regulation to protect us from big business, but in reality that regulation just increases the costs of everything we buy, rent, borrow, lease or steal (just kidding on that last part). Well, let’s take an example of over regulation at the FAA and how it will affect your Christmas. Toy drones are a big seller this year, and now the FAA wants to regulate them, so we should talk about his.

There was an interesting article in the Wall Street Journal on December 15, 2015 titled; “New Rules for Drone Owners” by Jack Nicas which noted that the FAA (Federal Aviation Administration) has a new rule going into effect that drone owners with even small drones of 1/2 pound or more must be registered with the administration. Those who bought their drones before December 21, 2015 have only until February 19, 2016. Now then the cost to register the drones is only $5 but the fee will be waived for the first 30-days.

Listen to this, the failure to register a drone carries the same weight as those who fail to register a commercial aircraft – namely up to $250,000 and 3-years in prison. Really for a toy drone bought from Wal-Mart or Toys-R-Us, are you kidding me, what are we going to put in jail every kid who got a little toy drone for Christmas and didn’t register it? It seems to me that the FAA has gone nuts, but this is typical of an overbearing Federal Agency. The FAA also is trying to administer property rights on asteroids, private space flight and people flying kits (well not yet, but don’t tempt them on the kites) as you’ll have to go to Afghanistan to go fly your kite?

Why is our government going overboard on all this? Well it seems that the terrorists are now considering using drones, they already are in the Middle East. Still, it’s a lot like registering assault weapons or cars, who is to say the terrorists are going to register these drones in their own names, they don’t seem to register their guns or cars with the various agencies that require such?

Why is the FAA getting involved in toy drones? Well they say that there were 221 incidents of small drones coming close to aircraft near airports in 2015. Still, 1/2 pound drones are fairly light and won’t do much damage, birds weigh more than that and they don’t have to register – whoops, I wouldn’t put this past the FAA.