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New Stark Law Regulations May Impact Many Physician Practices

In my experience, most physician groups rely on the “in-office ancillary service” exception to the Stark Law when determining how to allocate revenues from designated health services among group members.  The Stark Law is, of...more

Stark Law COVID-19 Waivers Extended to the Anti-Kickback Statute

The Centers for Medicare & Medicaid Services (CMS) issued Blanket Waivers of certain requirements of the Physician Self-Referral Law (Stark Law). The purpose for the Blanket Waivers is to provide the flexibility providers...more

Waiver Amounts Owed For Telehealth Services During The 2019 Novel Coronavirus (COVID-19) Outbreak

The Health and Human Services (HHS) Office of Inspector General (OIG) issued a Policy Statement on March 17, 2020 regarding the waiver of amounts owed by beneficiaries for services provided by telehealth. Recognizing the...more

Congress Creates a Mess by Enacting the Eliminating Kickbacks in Recovery Act of 2018

Congress has activated a new Anti-Kickback law known as Eliminating Kickbacks in Recovery Act of 2018 (commonly referred to as EKRA). The new Anti-Kickback law applies to arrangements involving recovery homes, clinical...more

OIG Opinion on Donation of Telehealth Equipment

A recent Advisory Opinion (Advisory Opinion 18-03) from the Office of Inspector General (OIG) of the Department of Health and Human Services addresses potential kickback issues involved in the donation of telehealth...more

Hospital Program for Free Support Services for Caregivers – Approved by OIG

A recent Office of Inspector General (OIG) advisory opinion approved a proposal under which a hospital has established a caregiver center that provides or arranges for free or reduced-cost support services to caregivers in...more

Treatment Center Pleads Guilty to Anti-kickback Statute Violations Involving Alcohol and Drug Addiction Treatment Centers

The Department of Justice (DOJ) recently announced the guilty plea of two individual alcohol and substance abuse treatment center owners for their participation in what the DOJ labeled a “multi-million dollar health care...more

Recent Fraud Settlements Illustrate Current Compliance Risk Areas

One of the reasons compliance officers and health care attorneys read fraud settlements is to identify issues the government is focused on. The cases the government decides to pursue are very indicative of the areas of fraud...more

Ambulatory Surgery Center (ASC) Case Demonstrates Differential Value Theory of Remuneration

A relatively recent case involving buy-in terms in an ambulatory surgery center demonstrates how different valuations for referral sources and non-referral sources can be evidence of remuneration under the Medicare...more

When to Use the OIG’s Self Disclosure Protocols

The HHS Office of Inspector General offers providers an opportunity to self-disclose certain violations in exchange for avoiding some of the more draconian penalties that may otherwise apply under applicable regulations. ...more

Ambulatory Surgery Center Physician Exclusions - Reducing Risk of Forced Redemption of ASC Investment Interests

Many surgery centers are eventually faced with decisions about how to treat investing physicians who do not perform as many procedures in the surgery center as others. Under performing physicians can create political issues...more

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