---
title: OIG and TOS Discounts
description: OIG and TOS Discounts
---

# OIG and TOS Discounts

March 11, 2008

[insurance](https://chipsblog.pcc.com/tag/insurance)

During my talks about proper pricing, a discussion often comes up relating to private pay patients and TOS discounts. Usually, it takes the following form:

- One physician objects to raising her prices because of all the poor families.
- I point out the practical flaw in this argument.  Only a few people notice.
- Another physician indicates that he resolves the issue by providing a TOS discount to those who pay fully.
- Someone then asks whether this practice is legal or not.
- Debate ensues, and I lose the class for five minutes.

Over on the [Medicare Update](http://medicareupdate.typepad.com) blog is an [analysis](http://medicareupdate.typepad.com/medicare_update/2008/02/oig-issues-advi.html) of an [OIG Advisory opinion](http://www.oig.hhs.gov/fraud/docs/advisoryopinions/2008/AdvOpn08-03A.pdf) about the legality of a hospital group doing just this.  They make it clear that TOS discounts for cash payers is certainly legal at least within the boundaries described in this case *and that's for Medicare patients!  *I see precedent here.

For those of you suffering from too many HSA programs, here's an answer (though I really don't like discounting your already discounted procedures).

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