State & Federal Anti-kickback Compliance

Anti-kickback statutes (AKS) exist at both the state and federal level. Federal law prescribes criminal penalties for individuals or entities that knowingly and voluntarily offer, solicit, pay for, or accept remuneration for the purpose of increased business covered by federal health care programs. For example, if a physician takes a gift or money from a drug or device sales representative, that physician may be liable for criminal or civil penalties. The physician cannot claim that the gift made no difference in the use of the drug or device as a defense.

The Office of Inspector General (OIG) affirms that rewarding an entity for referrals that use federal health care programs are strictly illegal. Anti-kickback laws try to prevent the health care market from falling into overutilization, higher costs, corruption, unfair competition, and improper patient care. These laws even prohibit the referral of patients, making it illegal to pay or accept payment for the referral of Medicare and Medicaid patients. G2Z Law Group, PLLC recognizes that fraud and abuse pose a great risk to health care providers. Our anti-kickback lawyers are prepared to help health care professionals and businesses address current and prevent future anti-kickback concerns.

What do Anti-kickback laws cover?

Renumeration under AKS is a broad term that includes anything of value. It includes cash value for meals and hotels, and it includes excessive compensation for health care consultations. The law applies to both the donor and the recipient of the renumeration. Exceptions to federal anti-kickback laws exist in the form of safe harbors. These arrangements are controlled by a specific set of criteria, and all requirements must be met before protection from civil and criminal penalties can be afforded.

Many states have specific rules under AKS. One such rule is the prohibition of the “corporate practice of medicine.” This rule forbids corporations from practicing medicine or employing a physician to provide professional services. In addition, Medicare rules vary from state to state and include discrepancies on the application of markup rules, conditional participation, or licensure and certification standards.

What can G2Z Law Group do for my health care business?

Criminal penalties for violating AKS include sanctions, fines, jail sentences, and expulsions from federal health care programs. Fines can be as high as $50,000 per violation in addition to a fine for up to three times of the remuneration amount. Violators of anti-kickback laws risk facing civil penalties as well. With so much at risk, health care professionals and businesses need effective programs to protect them from litigation. G2Z Law Group is here to evaluate your business’s risks and create effective programs to prevent and address anti-kickback violations.

Attorneys at G2Z Law Group can also defend you against investigations by the State or Federal agencies relating to violations of anti-kickback statutes.