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Anti-Kickback Statute › Physicians › Patient Referrals

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 -
Cozen O'Connor

Whistleblower Watch - Summer 2024

Cozen O'Connor on

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

Lathrop GPM

Now is Not the Time to Relax: Record Settlements in Stark Law and False Claims Cases

Lathrop GPM on

In early May 2024, the University of Pittsburgh Medical Center (UPMC) agreed to pay $38 million to resolve a False Claims Act case based on alleged Stark Law violations. The size of the settlement in United States ex rel. J....more

Stevens & Lee

U.S. Supreme Court Declines to Clarify Key Provisions of the False Claims and Anti-kickback Statutes

Stevens & Lee on

Last week, the U.S. Supreme Court denied the request of qui tam relators that it review the Sixth Circuit’s recent decision in United States of America ex rel. Martin v. Hathaway, No. 22-1463 (6th Cir.). In so doing, the...more

McDermott Will & Emery

OIG Issues Unfavorable Opinion on Laboratory Specimen Collection Payments to Hospitals

McDermott Will & Emery on

OIG has a long history of scrutinizing laboratory arrangements because of the agency’s view that these arrangements are particularly susceptible to fraud and abuse. Much of OIG’s past guidance focused on laboratory...more

Tarter Krinsky & Drogin LLP

The Anti-Kickback Statute and its Implications on Medical Practices

Tarter Krinsky & Drogin LLP on

The Anti-Kickback Statute (AKS) protects healthcare beneficiaries from the influence of money in their medical decision-making. Overall, the AKS criminalizes renumeration “intended to induce patient referrals or influence the...more

Tucker Arensberg, P.C.

“Stark” Rules: Navigating Physician Leases and Subleases

Tucker Arensberg, P.C. on

Under the Federal Ethics in Patient Referrals Act (more commonly known as “Stark”), if a physician has a financial relationship with an entity, the physician may not refer patients to the entity for medical services payable...more

Mintz - Health Care Viewpoints

Combatting Patient Leakage by Directing Physician Referrals: What is Permitted under the Stark Law?

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For many health care systems, patient leakage – when patients leave a health care system’s network in favor of out-of-network providers – is a rampant problem that results in substantial lost revenue. While sometimes patient...more

McGuireWoods LLP

Texas Court Allows FCA Case to Proceed Based on Purchasing “Future Referrals”

McGuireWoods LLP on

In United States ex rel. Roshan v. E. Tex. Med. Ctr., 2020 U.S. Dist. LEXIS 252092, 2020 WL 8918651 (E.D. Tex. (Nov. 24, 2020)), a Texas federal court partially dismissed a relator’s claim alleging the defendants engaged in...more

Oberheiden P.C.

EKRA Rules, Regulations & Compliance: 5 Tips that Health Care Providers Need to Know

Oberheiden P.C. on

Most health care providers have at least a basic understanding of the Anti-Kickback Statute. This federal law prohibits providers from offering, paying, soliciting, or accepting any form of “remuneration” for patient...more

Hogan Lovells

HHS Regulatory Sprint takes final shape: Part 1: Substantial Stark Law regulatory revisions adopted

Hogan Lovells on

Along with proposed Stark Law exceptions designed to accommodate value-based care models, the Centers for Medicare & Medicaid Services (CMS or the agency) adopted additional revisions to the Stark Law regulations (the final...more

Mintz - Health Care Viewpoints

West Virginia Hospital Enters into a $50 Million Settlement to Resolve Allegations over Excessive Compensation Paid to Referring...

Mintz - Health Care Viewpoints on

On September 9, 2020, the Department of Justice (DOJ) announced a $50 million settlement with Wheeling Hospital, Inc. of West Virginia to resolve False Claims Act allegations that Wheeling Hospital violated the Anti-Kickback...more

Buchalter

Nation’s First Conviction under EKRA

Buchalter on

What appears to be the United States’ first conviction under the Eliminating Kickbacks in Recovery Act (“EKRA”) occurred last month when the United States District Court for the Eastern District of Kentucky accepted the...more

The Volkov Law Group

Boston Heart Diagnostics Pays $26.67 Million to Settle False Claims Act Case

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Boston Heart Diagnostics, a Massachusetts company, agree to pay $26.7 million to settle a False Claims Act case involving allegations of paying illegal kickbacks to physicians....more

Bricker Graydon LLP

CMS proposes new Stark Law exception for limited remuneration to a physician

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On October 9, 2019, the Centers for Medicare and Medicare Services (CMS) released proposed changes to the regulations interpreting the Physician Self-Referral Law (Stark Law), including a new proposed exception for limited...more

Bass, Berry & Sims PLC

Believing in Conceiving: Private Equity’s Rebirth in the Fertility Sector

Bass, Berry & Sims PLC on

Following the launch of several platforms in recent years, it seems that private equity’s interest in the fertility space is trending up again. Investment in this sector brings some unique issues that potential investors...more

Robinson+Cole Health Law Diagnosis

CMS Proposes to Newly Define Commercially Reasonable, and Tweak Definition of Fair Market Value, in New Physician Self-Referral...

Robinson+Cole Health Law Diagnosis on

On October 17, 2019, the Centers for Medicare & Medicaid Services (CMS) formally published its proposed rule (the PSR Rule) to update exceptions to the Physician Self-Referral Law (PSR Law, also known as the Stark Law). For...more

Miles & Stockbridge P.C.

HHS Publishes Proposed Stark and AKS Updates

Miles & Stockbridge P.C. on

On October 9, 2019, the Department of Health and Human Services' Centers for Medicare and Medicaid ("CMS") and Office of Inspector General ("OIG"), respectively, published proposed rules updating the long-standing physician...more

Bricker Graydon LLP

CMS proposes to recalibrate the scope and application of the Stark regulations

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As part of the long-awaited proposed changes “to modernize and clarify” the regulations that interpret the Physician Self-Referral Law (the “Stark Law”) released on October 9, 2019, the Centers for Medicare and Medicaid...more

Holland & Knight LLP

Healthcare Law Update: October 2019

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In recent years, the healthcare industry has been turning greater attention to the need to engage or involve patients in developing new technologies and systems to improve healthcare delivery. These patient engagement...more

Holland & Knight LLP

Hospitals, Doctors (and Others) Beware: DOJ May Apply Travel Act to Healthcare Prosecutions - Arrangements Viewed Under the...

Holland & Knight LLP on

• A recent federal jury verdict in Dallas affirms the U.S. Department of Justice's determination to extend federal prosecutions to healthcare arrangements involving commercial payers by utilizing the federal Travel Act, which...more

Foley & Lardner LLP

ASCs Make Comeback with Multispecialty Ownership Groups

Foley & Lardner LLP on

Ambulatory surgery center (ASC) development and ownership has made a comeback after a number of years of stagnation due to an oversupply of centers and poor income growth. However, with significant changes in payment...more

Holland & Hart - Health Law Blog

Common Stark Concerns for Hospitals

Holland & Hart - Health Law Blog on

Unless structured properly, a hospital’s financial relationship with referring physicians or other providers may violate the federal Ethics in Patient Referrals Act (“Stark”) and Anti-Kickback Statute (“AKS”), resulting in...more

Bricker Graydon LLP

$24 million settlement resolves False Claims and Stark Law violations involving improper physician arrangements

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The Department of Justice (DOJ) recently announced that Montana’s Kalispell Regional Healthcare System (KRH) and six subsidiaries and related entities agreed to pay $24 million to resolve allegations that they violated the...more

Fox Rothschild LLP

New Anti-Kickback Law Targets Clinical Lab Marketing Arrangements, Referrals

Fox Rothschild LLP on

On October 24, 2018, Congress enacted a new anti-kickback statute that seemingly eliminates legal protections (i.e., "safe harbors") used by clinical laboratories to market their services. The statute, entitled the...more

The Volkov Law Group

Doctor and Two Medical Equipment Officers Head to Jail for Illegal Kickback Scheme

The Volkov Law Group on

The Justice Department’s commitment – resources and public statements – has continued at a steady pace in the Trump Administration. Some might diminish the effort by recognizing that fraud is so pervasive that it is like...more

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