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Home health & the AKS: Violation can lead to serious fines

There are times when a physician can best serve their patient by switching them to home health services. Physicians can sign off on these arrangements, but a failure to do so carefully can result in allegations of an Anti-Kickback Statute (AKS) violation. In a recent example, the United States Department of Justice (DOJ) accused a primary care physician from Houston of improperly signing off on patients for in-home services. The feds also claim the doctor received illegal payments connected to the patients’ medical care.

What do the feds claim the doctor did wrong?

The prosecution in this case essentially stated the doctor would “just rubber-stamp forms” for a specific home health services provider instead of carefully reviewing each patient’s application for home health services. The feds further claim that in exchange for signing off on patient care, he received “improper payments” from the provider in violation of the AKS.

What were the penalties?

Instead of a long legal battle, the physician chose to accept a plea deal and move on with his life. As part of the deal, the primary care provider will pay the government $475,000 in fines.

These investigations can have two additional ramifications. First, they often trigger an additional investigation from the state licensing board — potentially putting the physician’s medical license at risk. Second, they can take a long time from investigation to resolution. The initial federal investigation in this case began in 2016 and the case was not resolved until 2021. As a result of these complications, it is important for those who find themselves under investigation to take the matter seriously. A prompt response could help reduce the time it takes to reach a resolution while also mitigating the risk of damage to your medical license.