False Claims Act (FCA) [Healthcare Compliance Tips]
Stark Law [Healthcare Compliance Tips]
Anti-Kickback Statute [Healthcare Compliance Tips]
Examine the Anti-Kickback Statute (AKS) and determine whether your practice is in violation.
The Anti-Kickback Statute (AKS) can be difficult for practices to understand if one doesn’t know the exact definition or requirements.
Therefore, allow us to break it down and explain the following:
What is AKS?
Under this law, it is a crime to knowingly and willfully offer, pay, solicit, or receive any remuneration directly or indirectly to induce or reward referrals of items or services reimbursable by a Federal health care program.
Per CMS, remuneration includes anything of value, such as:
- Cash
- Free rent
- Expensive hotel stays
- Free meals
- Excessive compensation for medical directorships or consultancies
Also, don’t forget to review your state regulations regarding AKS.
How does AKS affect healthcare?
As shared by the OIG, kickbacks in healthcare can lead to:
- Overutilization
- Increased program costs
- Corruption of medical decision-making
- Patient steering
- Unfair competition
What are some examples?
- A provider receives cash or below-fair-market-value rent for medical office space in exchange for referrals.
- A provider receives free lunches, dinners, tickets to sporting events, electronics, etc., in exchange for referrals.
What are the penalties?
- Under the CMPL, penalties for violating this law may include three times the amount of the kickback, plus up to $100,000 per kickback (as of 2018).
- Individuals or entities may face criminal charges, which includes imprisonment and exclusion from participation in the Federal health care program.
What are “Safe Harbors?”
Under AKS, the safe harbor regulations are described as various payment and business practices that could potentially implicate the statute. But, they are not considered offenses under AKS if they meet certain requirements.
Click here if you would like to learn more about what safe harbors entail.
As you can see, there is so much at stake for your practice if you are found in violation of AKS. Therefore, if you are uncertain on how to proceed with referrals, please contact your legal team or a consultant for guidance.
In our next tip, we will compare the Anti-Kickback Statute (AKS) to the Stark Law. Although both laws are similar, there are several distinctions between the two. Feel free to review the comparison here.
**The opinions and observations from the group/author are not a promise to exempt your practice from fines and penalties. Research, modify, and tailor the advice to fit your specialty.
