Key Distinctions Between the Anti-Kickback Statute and Stark Law

samuel-zeller-360588-copy-200x300Though similar in purpose, the Anti-Kickback Statute (AKS) and Stark Law have many differences that are often overlooked or ignored by the general public. If you believe you have witnessed a form of healthcare fraud but are unsure whether the fraudulent act was a violation of the AKS or Stark Law, contact one of the experienced AKS and Stark Law attorneys at Willoughby Brod today for your free case review.

What is the Anti-Kickback Statute?

The AKS provides that physicians and hospitals are not permitted to refer patients to other healthcare providers in exchange for something of value, whether in cash or another form. The purpose of this statute is to ensure that referrals are genuine and based on merit rather than based on familial or professional networks.

What is Stark Law?

Stark Law prevents physicians from referring patients covered under Medicare to certain healthcare specialists with whom the physician has a financial relationship. “Financial relationship” is defined broadly by the federal government and includes any direct or indirect ownership or investment interest by the physician or the physician’s immediate family member.

Key Distinctions Between the Anti-Kickback Statute and Stark Law

Prohibited Persons

Under the AKS, all referrals are prohibited. However, under Stark Law, only referrals given by physicians are prohibited.

Physician Behavior

The AKS is much more strict with regards to prohibited physician behavior. Under the AKS, physicians cannot pay, offer, solicit, or receive anything of value in exchange for referral of patients to a federal healthcare program. Under Stark Law, on the other hand, physicians simply cannot refer a patient to a healthcare entity in which the physician has a financial interest.

Prohibited Products and Services

The AKS is again more strict than Stark Law when it comes to prohibited products and services. Under the AKS, no referrals of any kind, when attached to a kickback, are permitted. Under Stark Law, on the other hand, only referrals of designated health services, where a financial interest is involved, are prohibited.

Penalties

Penalties under the AKS can include civil and criminal penalties, whereas penalties under Stark Law only include civil penalties.

Intent

An intent element is required in an AKS claim but is not required in a Stark Law claim. Essentially, if you want to file a claim against an employer under the AKS, you must show an actual, unlawful intent. Showing mere mistake is not enough. Under Stark Law, on the other hand, intent is not a relevant factor because Stark Law is a strict liability statute.

Contact a Santa Rosa or San Francisco AKS or Stark Law Attorney Today

If you believe you may have witnessed a violation of the AKS or Stark Law or been involved in a transaction that was in violation of the AKS or Stark Law, contact one of our attorneys to have your case reviewed for free. Our attorneys will advise of the rules for each statute and its applicability to your case. Contact us online or at (800) 427-7020 today to speak with an experienced AKS or Stark Law attorney in the Santa Rosa and San Francisco area and receive a free consultation of your case.

(image courtesy of Samuel Zeller)