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.
When a payment is made as a return on an investment, such as a dividend from a stock option, this is not considered a violation of the Anti-Kickback statute. However, there are several provisions that must be met before healthcare professionals are protected under this safe harbor. For example, when the payment is related to an equity security, that security must be registered with the Securities and Exchange Commission.
Doctors and healthcare professionals need a building to set up their practice. Most of the time, these buildings are leased, or rented, for a certain amount of money every month. Due to the fact that this is a vital part of the clinic or other healthcare facility, and therefore crucial to providing quality healthcare to patients, healthcare professionals that pay to lease a building from a landlord, or lessor, are protected under the Anti-Kickback statute.
Sometimes, healthcare professionals have to pay other professionals for their services. For example, a pharmacy may have to pay a doctor or nurse to come in for a flu clinic and administer the flu shot to patients who request it. When the pharmacy fairly compensates the other healthcare professional for rendering this service, this is not considered a violation of the Anti-Kickback statute.
At times, healthcare facilities have to rent certain equipment. For example, a hospital may rent surgical lasers or other surgical tools. If the hospital pays appropriate compensation to the lessor, this is not considered a violation of the Anti-Kickback statute.
Did You See Wrongdoing in a Healthcare Setting? Call Our California Qui Tam Lawyers
At first, the Anti-Kickback statute seems fairly straightforward. However, there are provisions within it that protect healthcare professionals, and they can be confusing. If you think you have seen wrongdoing that defrauds patients or the federal government, and you want to make it right, our San Francisco qui tam lawyers can help. At Willoughby Brod, LLP, we have the necessary experience to file qui tam claims properly and give whistleblowers the best chance of a positive outcome. Call us today at (800) 427-7020 to schedule a free case evaluation so we can review your case.