Under the federal Anti-Kickback statute, doctors and other healthcare professionals are prohibited from knowingly or willfully paying, offering, soliciting, or accepting remuneration in exchange for patient referrals. Under the statute, it is also illegal to offer something of value or pay for payments of goods and services that healthcare professionals are reimbursed for by the federal government.
The purpose of the law is to protect both patients and the federal government from fraud and abuse by involving money in healthcare decisions. The penalties for violating the Anti-Kickback statute are steep. Healthcare professionals can face up to ten years in federal prison, a fine of $100,000, or both. However, healthcare professionals are also protected by several ‘safe harbors’ under the law. These are provisions that give healthcare professionals immunity from the Anti-Kickback statute. Although there are several safe harbors, the most common are found below.
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There are many different types of whistleblower claims that involve physicians and other medical providers defrauding the government. Some of the most common involve Stark Law violations. Stark Law was enacted over two decades ago and was meant to ensure that patients receive the best care possible, and that physicians always work in their best interests. Today, Stark Law has become complicated, and it seems the laws are changing all the time. If you work in the medical industry, below are five things you should know about Stark Law to ensure your employer operates honestly and within the confines of the law.
Those who are under investigation for health care fraud may face years in federal prison if they are found guilty, or they ay face civil charges that result in much less severe penalties. It is up to the discretion of the federal prosecutor to determine if the case will be criminal or civil. If you have come forward to report health care fraud, how do you know whether those you have turned in will face criminal or civil charges?
On December 21, 2018, the Department of Justice released its statistics for Fiscal Year 2018 for actions taken under the Federal False Claims Act. The
Every day we hear shocking news about the opioid epidemic, from the number of deaths from overdoses to the sheer amount of distribution arrests to the amount of money government is spending to combat the problem. One of the areas that the public may not know about, however, is how much of the problem is being created by dishonest health care professionals across the country through fraud and illegal practices.
There is no such thing as “good” fraud, but on the hierarchy of Medicare fraud from bad to worst, hospice fraud is arguably one of the most despicable types. Medicare Part A covers hospice care for patients who are “
One common category of healthcare fraud schemes in the medical laboratory industry revolves around medically unnecessary testing. There are many different ways in which the medical laboratory industry fraudulently commits medically unnecessary testing, which are highlighted below. If you believe you have witnessed healthcare fraud involving medically unnecessary testing, contact the