As a medical professional, people’s lives are in your hands. Therefore, much of the healthcare industry relies on ethical integrity. The highest priority in your work should always be the well-being of your patients — not financial gain. However, you would be surprised how often this morality is dismissed.
Anti Kickback laws (including pharmacy Anti Kickback policy) exist to prevent corruption and personal gain in healthcare. Violations of this law suggest that medical professionals are prioritizing financial incentives over ethical considerations, thus compromising patient care.
The Anti-Kickback Statute prohibits financial transactions that reward referrals for products and services reimbursed by U.S. federal healthcare programs. According to the Health and Human Services, Office of Inspector General, paying for referrals is a crime in Federal healthcare programs.
Let’s say a hospital offers a financial incentive to a clinic for referring patients to its facility for surgeries that are covered by Medicare. This “bribe” would be prohibited under the Anti-Kickback Statute.
Anti-kickback laws prevent corruption by prohibiting financial gain from influencing medical decisions. It ensures that medical professionals make decisions based on the best interests of their patients as opposed to financial incentives.
Violating the Anti-Kickback Statute can lead to serious consequences, such as fines, imprisonment, and exclusion from participating in Federal healthcare programs.
If you suspect that a colleague is accepting kickbacks, whether they confide in you or you witness it directly, it is your duty as a medical professional to take the appropriate steps to address the issue responsibly.
Here are the steps you should consider following.
Record any details or evidence related to the suspected kickbacks. This might include dates, times, locations, photos, and any witnesses or documentation that supports your suspicions. Be as thorough and accurate as possible to ensure that your report is credible.
Review your healthcare practice’s policies on reporting unethical behavior, as well as the relevant state laws and regulations. Following these policies, report the incident internally to your supervisor or human resources (HR). Provide all the information and evidence that you have gathered to support your report.
The American Medical Association advises that if internal reporting does not resolve the issue, or if the conduct poses an immediate threat to patient safety or violates state licensing provisions, you should report the behavior to appropriate clinical authorities. This includes notifying the state licensing board if the conduct is particularly serious. External reporting helps ensure that the issue is addressed immediately and patient safety and professional standards are upheld.
Protect the confidentiality of your report where possible. Avoid discussing the matter with others on your team to prevent unnecessary rumors and ensure a fair investigation. Limiting discussions about the report is also crucial to maintain the privacy of any patients who may have been involved.
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.