News & Analysis as of

Anti-Kickback Statute Physicians Healthcare Fraud

The Anti-Kickback Statute is a United States federal criminal statute that prohibits the exchange (or the promise to exchange) of anything of value for referrals of federal healthcare program business. The... more +
The Anti-Kickback Statute is a United States federal criminal statute that prohibits the exchange (or the promise to exchange) of anything of value for referrals of federal healthcare program business. The statute aims to prevent situations where government officials channel federal healthcare dollars towards particular providers, who have offered or given the official a personal benefit. Penalties for violation of the Anti-Kickback statute apply to both sides of a prohibited transaction and can include jail time and steep monetary fines. less -
Dentons

Ep. 30 – Ensuring Payments to Physicians for Administrative Services Meet a Stark Exception

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Providers will often pay physicians for serving in important administrative roles within the organization. Compensation for administrative services can create risk to the organization under multiple laws, including the...more

Husch Blackwell LLP

False Claims Act Insights - Are All Healthcare “Kickbacks” Subject to FCA Liability?

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Host Jonathan Porter welcomes Georgia Deputy Attorney General Jim Mooney to the show to explore the intersection of the False Claims Act (FCA) and the federal Anti-Kickback Statute (AKS). Our discussion begins with an...more

Cozen O'Connor

Whistleblower Watch - Summer 2024

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Whistleblower Watch is a comprehensive source for all False Claims Act (FCA) news and information. Every quarter, Cozen O’Connor will provide in-house counsel and compliance professionals with a summary of the most notable...more

Wiley Rein LLP

Hot Fraud Summer: DOJ’s Latest Criminal Takedown

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The U.S. Department of Justice (DOJ) Criminal Division’s Health Care Fraud Strike Force announced the results of its latest nationwide enforcement action on June 27, 2024, one year (almost to the day) since its last major...more

Dentons

Ep. 12 - Working with Valuation Experts to Substantiate Fair Market Value Compensation

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We often work with valuation experts to ensure compensation payments between healthcare organizations and physicians are fair market value and commercially reasonable for purposes of compliance with the Stark Law and the...more

Polsinelli

Health Care Fraud and Abuse 2023 Year in Review

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Introduction - Polsinelli proudly introduces the Health Care Fraud and Abuse 2023 Year in Review, a comprehensive examination of the evolving landscape surrounding the False Claims Act (“FCA”) and fraud & abuse enforcement...more

Pietragallo Gordon Alfano Bosick & Raspanti,...

Private Equity Brings Inequity To The ER

As experienced whistleblower counsel, with more than a decade of representing emergency providers in false claims act (FCA) cases against large hospital systems and national hospital-based staffing groups, the recent...more

Bass, Berry & Sims PLC

12th Annual Healthcare Fraud & Abuse Review - A Critical Resource for Healthcare Providers

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We are pleased to bring you our 12th annual Healthcare Fraud & Abuse Review. Our Review provides comprehensive coverage of the most significant civil and criminal enforcement issues facing healthcare providers. Each year, we...more

Husch Blackwell LLP

Federal Court Reduces FCA Penalties by 82 Percent Because of Excessive Fines Clause Concerns

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Husch Blackwell’s False Claims Act team previously covered the results of a rare False Claims Act (FCA) trial in which a federal jury found that a surgical product distributor was liable for paying kickbacks to physicians....more

Health Care Compliance Association (HCCA)

In Biggest Stark-Based FCA Settlement Ever, Indiana Hospital Pays $345M, Has Unusual CIA

Community Health Network (CHN) in Indiana has agreed to pay $345 million to settle false claims allegations that it paid over-the-top salaries to hundreds of physicians and rewarded them for their referrals in violation of...more

Mintz

EnforceMintz — Some of 2023’s Largest FCA Resolutions Involved Stark Law Allegations

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The Physician Self-Referral Law — known as the “Stark Law” — broadly prohibits physicians from profiting from self-referrals for “designated health services” (DHS) payable by Medicare or Medicaid. For example, the Stark Law...more

Health Care Compliance Association (HCCA)

[Event] 28th Annual Compliance Institute - April 14th - 17th, Nashville, TN

Get ready to be inspired with game-changing insights and industry connections! For over two and a half decades, healthcare compliance professionals have gathered at HCCA’s Compliance Institute (CI) to share ideas, learn...more

Jones Day

HHS-OIG Issues Long-Anticipated General Compliance Program Guidance for All Health Care Stakeholders

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In Short - The Situation: On November 6, 2023, the Office of Inspector General ("OIG") of the U.S. Department of Health and Human Services ("HHS") released its "General Compliance Program Guidance" ("GCPG"). The GCPG...more

Bass, Berry & Sims PLC

[Webinar] 9th Annual Nashville Healthcare Fraud Conference - December 14th - 15th, 9:00 am - 2:00 pm CST

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Please join us for the 9th Annual Nashville Healthcare Fraud Conference hosted by Bass, Berry & Sims and the Tennessee Hospital Association. Eligible for more than seven hours of CLE credit (including ethics), this...more

Bass, Berry & Sims PLC

[Event] 9th Annual Nashville Healthcare Fraud Conference - December 7th, Nashville, TN

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Please join us for the 9th Annual Nashville Healthcare Fraud Conference hosted by Bass, Berry & Sims and the Tennessee Hospital Association. Eligible for more than seven hours of CLE credit (including ethics), this...more

McGuireWoods LLP

Lessons for Providers and Practice Entities: Ophthalmology Groups Pay Millions to Settle Co-Management, Optometrist Relationship...

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Recently, two ophthalmology practice groups — Kleiman Evangelista Eye Centers of Texas (KEEC) and SouthEast Eye Specialists, PLLC (SEES) — reached large settlements with the U.S. government over allegations that the groups’...more

Rivkin Radler LLP

NY Cardiologist Settles AKS Claims for $6.5 Million

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The U.S. Attorney’s Office for the Southern District of New York announced on September 18 that cardiologist Klaus Peter Rentrop and his practice, Gramercy Cardiac Diagnostic Services, P.C., agreed to pay $6.5 million to...more

Manatt, Phelps & Phillips, LLP

[Webinar] Emerging Fraudulent Schemes in Health Care: A Guide to Protecting Plan and Provider Organizations - October 17th, 10:00...

Over the past few years, there has been tightening enforcement and numerous lawsuits driven by the increasingly complex web of federal and state anti-kickback and anti-inducement statutes. In a new CLE-eligible webinar,...more

Epstein Becker & Green

Physicians Beware! Groups Providing DME, Prosthetic Devices, and Other Medical Supplies to Their Medicare Patients Risk Violating...

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When the COVID-19 Public Health Emergency (“PHE”) ended on May 11, 2023, many physician groups furnishing certain medical equipment, devices, and/or supplies to their Medicare patients became in violation of the federal...more

Health Care Compliance Association (HCCA)

[Event] 2023 Healthcare Enforcement Compliance Conference - November 5th - 7th, Washington, DC

Hear directly from the enforcement community - Want to gain insight into properly monitoring, detecting, investigating, and managing violations? Join us at HCCA’s Annual Healthcare Enforcement Compliance Conference to...more

Bass, Berry & Sims PLC

False Claims Act Settlements to Know from Q2 2023

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There have been several noteworthy False Claims Act (FCA) settlements in the second quarter of 2023.  Four of these settlements have come in over $20 million. This post summarizes key settlements of interest....more

McDermott Will & Emery

Healthcare Regulatory Check-Up Newsletter | May 2023 Recap

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This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity for May 2023. We discuss several criminal and civil enforcement actions that involve violations of the False Claims Act (FCA)...more

Cooley LLP

Are Courts Reining in Causation and Remuneration in False Claims Act and Anti-Kickback Cases?

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In US ex rel. Martin v. Hathaway, the US Court of Appeals for the Sixth Circuit joined the US Court of Appeals for the Eighth Circuit in requiring False Claims Act (FCA) plaintiffs to establish a direct causal relationship...more

Maynard Nexsen

New Stark Law and Anti-Kickback Statute Physician Wellness Program Exception

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The Physician Self-Referral Law (the “Stark Law”) and Anti-Kickback Statute (“AKS”) are two of the most prominent healthcare fraud and abuse laws in the United States. The Stark Law and AKS have been in place for many years...more

Robinson+Cole Health Law Diagnosis

Stark Settlement Targeting Hospital and Physicians a Reminder for Health Care Organizations

On March 29, 2023, the Department of Justice’s (DOJ) Office for the Eastern District of Michigan announced a notable set of three settlements (collectively, the Settlement) in excess of $69 million dollars total with a...more

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