The Stark Law and Anti Kickback laws, including the pharmacy Anti Kickback policy, are crucial in healthcare to prevent corruption and personal gain. Violations of these laws indicate that medical professionals are prioritizing financial incentives over ethical considerations, potentially compromising patient care.
Violating anti-kickback laws is considered corrupt and can lead to serious consequences for both employees and the healthcare practice as a whole. Below are some notable anti-kickback cases you may not be aware of, along with tips on how to avoid similar legal pitfalls.
The Anti-Kickback Statute is a federal law that prohibits financial transactions designed to reward referrals for products and services covered by U.S. federal healthcare programs. It criminalizes bribery and the payment of incentives for referrals, aiming to maintain the integrity of healthcare services.
By preventing financial gain from influencing medical decisions, California’s Anti-Kickback Statute and related laws help protect patients and ensure that medical professionals prioritize ethical care over profit.
BALANCE, a New York-based diagnostic testing facility, engaged in a scheme where they paid kickbacks to doctors in exchange for patient referrals. These referrals led to diagnostic tests that were billed to Medicare and Medicaid.
To disguise the illegal payments, BALANCE made it appear as though they were paying doctors rent for office space when in reality, the payments were bribes for patient referrals.
The lawsuit was filed under the False Claims Act, which allows whistleblowers to report fraud on behalf of the government. As part of the settlement, BALANCE will pay $1,725,850 to the U.S. government and $774,150 to the State of New York, for a total of a $2.5 million settlement.
Several marketers, their companies, and five doctors have agreed to pay over $1.5 million to settle accusations of being involved in illegal kickback schemes. These schemes involved paying doctors in exchange for referring patients to specific labs for tests that were then billed to Medicare.
The labs, marketers, and doctors disguised these payments as fees for consulting or other services, but they were actually bribes for referrals.
Admera Health LLC, a New Jersey-based biopharmaceutical research and lab testing company, has agreed to pay over $5 million to settle allegations that it violated the False Claims Act.
Admera Health paid independent marketers to get healthcare providers to order genetic tests covered by Medicare and Medicaid, which is illegal under the Anti-Kickback Statute.
The cases above highlight how medical professionals violated anti-kickback laws, which are in place to prevent illegal bribes that compromise patient care. Government involvement is necessary to ensure that healthcare decisions are based on patient needs, not financial incentives.
Here are some tips to help your healthcare practice avoid Anti Kickback violations:
These measures will help your practice stay compliant and prevent legal issues related to kickbacks.
Fenton Jurkowitz Law Group has a team of seasoned anti-kickback healthcare attorneys who are well-versed in California anti-kickback statutes. It is important to have legal counsel on your side when filing a report to authorities to ensure you and your healthcare practice are protected. Fill out our contact form on our website today to connect with a healthcare practice attorney.