Purpose

ABAS does not offer gifts, money, or other things of value to influence a client's, family's, or prospective client's choice of provider. This policy defines what counts as an improper inducement to clients, families, and prospective clients, states the narrow exceptions, and assigns responsibility for keeping gifts, fee decisions, and outreach within legal limits. It exists so that families choose ABAS for the quality of its services, not because of gifts or financial incentives.

Scope

This policy applies to all ABAS employees who interact with clients, families, or prospective clients, including the BCBA Team, the Behavior Technician Team, the Billing & Recovery Specialist, and the Administration Team responsible for outreach, marketing, and intake. It covers anything of value offered or given to a client, family, or prospective client, including gifts, waived or reduced copayments or fees, and free goods or services, in every setting where ABAS delivers or markets services. Remuneration offered to referral sources is outside the scope of this policy and is addressed under ABAS's anti-kickback provisions (see Section 5.6).

Definitions

Policy Statement

5.1 Prohibition

ABAS prohibits offering, giving, or authorizing anything of value to a client, family member, or prospective client when ABAS knows or should know it is likely to influence that person's selection of, or decision to remain with, ABAS as a provider. ABAS applies this standard to every client as a matter of ethical integrity, regardless of payer. It also reflects the beneficiary inducement provision of the federal Civil Monetary Penalties Law (42 U.S.C. § 1320a-7a(a)(5)), which governs federal and state health care program beneficiaries. An inducement is improper even when it is offered with good intentions.

5.2 Prohibited Conduct

The following are prohibited. This list is illustrative, not exhaustive:

1. Giving cash, gift cards, or other cash equivalents to clients or families in any amount.
2. Routinely waiving or reducing copayments or other amounts a client owes.
3. Advertising or promising free items, free services, fee waivers, or gifts to attract clients to ABAS.
4. Offering gifts, prizes, or raffle entries conditioned on enrolling with ABAS, remaining a client of ABAS, or referring other families to ABAS.
5. Providing goods or services free of charge, outside an authorized treatment plan, to attract or retain a client.

5.3 Nominal Value Exception

The prohibition does not reach items of nominal value. The nominal-value limit, which tracks current OIG nominal-value guidance, is set in STD-001 (Gift and Courtesy Standard). A nominal item must never be cash or a cash equivalent, must not be advertised, and must not be conditioned on selecting or staying with ABAS. The Compliance Officer keeps a record of nominal items given to each client and family so the annual aggregate can be confirmed against the limit, and monitors OIG updates to the threshold. Employees who are unsure whether an item qualifies must ask the Compliance Officer before giving it.

5.4 Clinical Reinforcers

Items and activities used as reinforcers during treatment, under a client's authorized treatment plan, are clinical tools and are not inducements under this policy. The BCBA Team selects reinforcers based on clinical need and documents them in the treatment plan. A reinforcer is an ordinary, low-cost clinical tool; an item of significant independent value is not a reinforcer and is treated as a gift under Sections 5.1 through 5.3. Items given to a client or family outside the treatment plan are gifts and are subject to Sections 5.1 through 5.3.

5.5 Fee Waivers Based on Financial Need

ABAS does not routinely waive or reduce amounts a client owes. A waiver or reduction is permitted only when it is not advertised, is not routine, and follows a good-faith, individualized determination of financial need or a reasonable failed effort to collect. Every waiver requires a written determination approved by the Compliance Officer before it takes effect, documented per Section 6.

5.6 Distinction from Anti-Kickback Requirements

This policy governs inducements offered to clients, families, and prospective clients. Remuneration involving referral sources, meaning anyone in a position to refer clients to ABAS, is governed by the federal Anti-Kickback Statute and is addressed in POL-004 (Fraud, Waste, and Abuse Prevention), Section 5.4, and in POL-005 (Anti-Kickback Statutes). Employees must direct questions about either type of arrangement to the Compliance Officer before acting.

Procedures

Responsibilities

Steps

1. Before giving a client or family any item outside the treatment plan, employees confirm it meets the limits in Section 5.3, checking the proposed item against the Section 5.3 log for that client and calendar year, or obtain Compliance Officer approval.
2. Requests to waive or reduce an amount a client owes go to the Billing & Recovery Specialist, who escalates them to the Compliance Officer. The Compliance Officer documents the individualized financial need determination in writing before any waiver takes effect.
3. The Compliance Officer reviews marketing, outreach, and intake materials before use to confirm they contain no offers of free items, free services, fee waivers, or gifts.
4. Suspected violations are reported and handled under POL-003 and its Compliance Ticket Management SOP.
5. The Compliance Officer reports approvals granted, questions raised, and confirmed issues under this policy to the Compliance Committee.

Training Requirements

All ABAS employees must complete training on this policy during onboarding and at least annually thereafter as part of compliance refresher training. Client-facing employees, including the BCBA Team and Behavior Technician Team, receive role-specific training on the line between clinical reinforcers and gifts. The Billing & Recovery Specialist receives role-specific training on the fee waiver requirements in Section 5.5. The Compliance Officer tracks completion and reports completion rates to the Compliance Committee.

Reporting and Enforcement

Employees who become aware of a gift, fee waiver, or other item of value that may violate this policy must report it through the channels described in POL-003 (Compliance Reporting, Investigation, and Resolution), including the anonymous web form and the compliance ticketing system. Reports are investigated under POL-003 and its Compliance Ticket Management SOP. A confirmed violation may result in corrective action up to and including termination, and can expose ABAS to civil monetary penalties and exclusion from federal and state health care programs, including referral to MassHealth or other authorities where required by law. ABAS will not retaliate against any person who reports a concern in good faith.