Articles Tagged with Anti-Kickback Statute Law Firm

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.

ken-treloar-385255-copy-300x200Even though the Anti-Kickback Statute is a federal criminal statute that results in serious penalties when violated, it is also one that physicians and healthcare professionals violate on a regular basis. If you believe you were referred to a physician or other healthcare provider as part of a monetary or other valuable exchange, you may have witnessed an Anti-Kickback Law violation. However, there are certain “safe harbors” that protect physician payment plans that would otherwise constitute a violation under the Anti-Kickback Statute. If you are unsure whether your physician’s payment plan falls into one of the safe harbors, contact the attorneys at Willoughby Brod to get your questions answered.

What is the Anti-Kickback Law?

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

healthcashAs concerned citizens and as a health care fraud law firm, our team continues to be pleased with the terrific successes whistleblowers are having using the False Claims Act, Anti-Kickback Statute and related federal and state statutes to fight fraud in the medical field.   A major settlement announced this month involving improper health care kickbacks shows just how successful these cases can be and how several different laws can work in concert to provide justice.  Yet, we know that for every victory, there are countless other companies and individuals committing health care fraud and stealing from the American people.  We cover these issues extensively to let those who witness these crimes know they are not alone.  We are here to help them follow the right path and truly do a service to their country.

DOJ Announces Largest Total Settlement Involving Illegal Kickbacks in Medical Device Field

The Department of Justice (“DOJ”) announced this month that the largest distributor of endoscopes and related equipment has agreed to pay $623.2 million to settle several lawsuits involving allegations it paid inappropriate kickbacks to doctors and hospitals.  Defendant Olympus Corporation of the Americas (“Olympus”) has admitted to the allegations in a criminal complaint filed in a New Jersey federal court based on the Anti-Kickback Statute (“AKS”) and the related suits rest on similar allegations.  This settlement involves the largest total amount paid to date by a medical device company for violations involving the AKS.  Olympus has entered into a deferred prosecution agreement that allows it to avoid criminal conviction if it complies with the reforms contained in the agreement.

The relationship between health care and money is the crux of some of the biggest policy debates of our time.  Still, while much is debated, there are also many principles that most Americans agree should hold true.  One such maxim – Medical decisions should be based on the best interests of patients, not providers own financial well-being.  This precept is reflected in several laws including the Anti-Kickback Statute and the Stark Act and enforcing these rules is one of the goals of our work as a whistleblowers’ law firm for health care fraud issues.

$115 Million Settlement Resolves Case Alleging Health System’s Bonuses Violated Law

Just last week, the Justice Department (“DOJ”) announced a major settlement in a health care fraud case involving allegations of improper financial relationships between health care providers and their referral sources.  The lawsuit claimed that Adventist Health Systems, a healthcare organization with facilities in 10 states, billed for the services of employed providers who were paid bonuses that, contrary to law, were based on a formula that considered the value of the referrals to the hospital system.  More specifically, the suit alleged that doctors received monetary bonuses tied to the number of tests and procedures they ordered.  Adventist agreed to pay $115 million to settle these and other fraud allegations, but did not admit to any wrongdoing.