Overview
- HHS-OIG Advisory Opinion No. 25-12, issued in January 2026, finds a proposed sign-on bonus program for prospective attendants unfavorable under the Anti-Kickback Statute and the Beneficiary Inducements CMP.
- The employee safe harbor did not apply because attendants—often relatives—would select the agency for Medicaid-covered clients, creating an "inextricable link" between employment and a referral.
- OIG determined that marketing the bonus to would-be attendants operates as client solicitation and could steer choices based on bonus size rather than quality of care.
- The opinion highlights market risks, including escalating bonus competition and potential diversion of resources from services to recruitment payments.
- Legal analyses urge home care providers to reassess recruitment incentives and seek counsel, noting the opinion’s narrow, fact-specific focus and the lack of disclosed agency or state details.