Anti Kickback Penalty Case Study
The Federal Anti-Kickback Statute (42 U.S.C. 1320a-7(b)) restricts suppliers of goods or services secured by a government healthcare program ("Federal Healthcare Program") from intentionally and readily requesting or accepting or giving any compensation, directly or indirectly, in trade or in kind, to actuate either the referral of an individual, or outfitting or orchestrating a good or service for which imbursement may be made under a Federal Healthcare Program. The Federal Anti-Kickback Statute is a goal based statute.
Certain dealings and engagements are statutorily absolved from the Federal Anti-Kickback Statute (e.g., remuneration paid in accordance with a legitimate employment relationship). Furthermore, dealings and engagements …show more content…
According to research, the health care industry is more exposed to scam than any other industry. The health care fraud comes into existence because of the increasing health care cost. Health care deception is seen as an abuse on health care resources. Due to health care fraud, U.S is facing a huge amount of loss every year. Because health care fraud has played such a very important role in raising the cost of health care it has gained a lot of consideration from the government and the United States …show more content…
The government has taken these frauds into consideration, and begun to make attempts to eradicate their presence. The federal anti kickback law has been evolved to protect patients and health care institutions from crime and misuse. To eradicate corruption from the health care industry, 13 safe harbors have been published.
The safe harbors addresses and monitor the payment practices of the following sector: investment in public health care companies, investment in small health care ventures, space rental, equipment rental and training of staff. The main purpose of safe harbor is to provide a safe passage for payments and to keep a check on illegal gains by medical experts and physicians..
The “stark law” mentioned in section 1877 of the social security act, pertains to physician referrals under Medicare and Medicaid. According to this law the physician cannot refer a person who has a financial relationship with the physician, for designated health services.
Fraud and Abuse Issues Affecting Hospitals &