The government expects healthcare providers to focus on patient care over financial gain. There are many regulations in place to help better ensure patients are protected and reduce the risk of temptation for healthcare professionals, but there are still those who...
Stark Law/Anti-Kickback Statutes
Kickback or legit payment? The answer can mean the difference between freedom and prison time.
Officials throughout the country continue to crackdown on potential healthcare fraud cases. The primary motivator is one of the oldest and strongest: money. The feds get billions back from healthcare fraud cases every year. How do these cases work? The government is...
Court cracks down on personal service safe harbor
The Anti-Kickback Statute (AKS) makes it illegal to encourage referrals for Medicare services in exchange for renumeration or other types of payment. There are some exceptions, referred to as safe harbors. One example is the personal services and contracts safe...
Feds see North Texas as a “hotbed” for healthcare fraud
Everything is bigger in Texas, and as far as the feds are concerned that old adage holds true for healthcare fraud in recent years. In the past, the feds could generally only pursue allegations of illegal kickbacks against providers who billed federal programs....
Are payment assistance programs a violation of the AKS?
The Anti-Kickback Statute (AKS) is a federal law enacted by lawmakers to help reduce the risk that medical professionals would use financial motivation to guide medical decisions. This intent is good, but the application can go awry. One example involves the use of...
3 lessons from “referral” case for AKS violations
The term “referral” is not clearly defined within the Anti-Kickback Statue (AKS). This ambiguity can make it difficult when building relationships with other healthcare providers. A recent case provides a reminder for the need to tread carefully when making these...
Feds accuse health records vendor of AKS violation
The federal Anti-Kickback Statute (AKS) is one of the most well-known anti-fraud laws in the country. This criminal statute has a huge impact on the healthcare industry and can affect physicians, executives, lab owners and anyone else that files claims for payment...
Physician faces decades imprisonment for healthcare fraud
Feds recently accused a physician of falsely certifying patients for home health services. The prosecution is aggressively building a case against the medical professional and claims that she received financial incentive for these certifications. What exactly...
The feds say my COVID-19 testing lab violated EKRA, now what?
The federal government chose to ease enforcement of certain regulations during the COVID-19 pandemic, but the Eliminating Kickbacks in Recovery Act (EKRA) was not one of them. This provision within the Substance Use-Disorder Prevention that Promotes Opioid Recovery...
Can a neurosurgeon have ties to a medical device company?
The United States Department of Justice (DOJ) recently announced a settlement between the feds and a neurosurgeon. The neurosurgeon owned two medical device distributorships and was accused of the following: The feds state the accused used illegal kickbacks to...