Psychiatrists provide important care. Like any other form of medical care, these services are often billable to insurance companies, both private and federal. As such, the practices fall under many forms of federal and state regulations. Four of the most important...
Stark Law/Anti-Kickback Statutes
Hospice centers face scrutiny for potential AKS and Stark Law violations
The United States Centers for Medicare and Medicaid Services (CMS) has strict rules when it comes to business relationships between healthcare providers who file claims for payment from Medicare. Two primary examples are the Anti-Kickback Statute (AKS) and the Stark...
What are safe harbors for the Anti-Kickback Statute?
The Anti-Kickback Statute (AKS) is a federal law that lawmakers intend to help better ensure physicians and other medical professionals focus on quality healthcare over financial gain. The law makes it illegal to file false or fraudulent claims for payment with...
When does an investment lead to a Stark Law violation?
Physicians often have more financial flexibility than the general public. They can often find high paying jobs and set themselves up with extra funds to pursue different investment options. In some cases, these strategies can lead to a steady stream of additional...
Texas optical company pays millions to settle AKS case
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...
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...