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Federal Anti-Kickback Statute violations

On Behalf of | Feb 11, 2022 | healthcare fraud | 0 comments

Certain actions by medical providers involving federal health care programs may lead to charges. The Anti-Kickback Statute forbids accepting or offering cash or other gratuities in exchange for patient referrals.

When health care involves services paid for by federal funds, medical professionals accepting or providing patient referrals may not exchange gifts or compensation. This practice, also referred to as “remuneration,” may reflect a violation of the AKS. According to Cornell University’s Legal Information Institute, remuneration in the form of discounts may also violate the law.

Activities the law may consider kick-backs

The Office of Inspector General’s website notes that offering a clinic free rent may classify as remuneration or a kick-back. Health care providers receiving expensive meals or travel perks may reflect a violation. Doctors may also risk allegations if they prescribe pharmaceuticals when they own stocks in the companies producing them.

Companies may not provide discounts to medical staff members in exchange for federally funded items. A health center’s landlord may not offer rent reductions in exchange for medical services paid for by the government.

Safe harbor actions may serve as a defense

The OIG’s Safe Harbor Regulations offer relief from prosecution for certain arrangements. As reported by Policy & Medicine, the safe harbor updates include provisions for cybersecurity technology and services. Reciprocal actions designed to engage and support patients may provide safety from prosecution. Providing encrypted software, for example, protects patients’ electronic health records. Improving the quality of care may outweigh the alleged offense.

The AKS may prevent doctors from prioritizing referrals to health care professionals working through federal programs. Safe harbor provisions, however, protect doctors from unjust allegations. Prosecuting a physician exercising good intent may not uphold a duty of care or help a patient recover.