News & Analysis as of September 21, 2024

Anti-Kickback Statute › Referral Fees

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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 -

OIG Approves Discount Medical Plan Arrangement with Chiropractors in Advisory Opinion 20-03

Baker Donelson on 7/27/2020

In Advisory Opinion 20-03, published July 1, 2020, the Office of Inspector General (OIG) approved an arrangement in which a discount medical plan organization (DMPO) that receives annual membership fees from its members also...more

FCA Issues to Watch: FCA Claims Concerning Physician Compensation

Bass, Berry & Sims PLC on 5/5/2017

Physician employment arrangements with hospitals have remained a significant area of regulatory scrutiny in recent months with the announcement of several high profile settlements and decisions in key FCA cases involving...more

The Federal Government Holds Individuals Responsible for Involvement in Corporate Healthcare Fraud and Abuse

Sherman & Howard L.L.C. on 11/29/2016

In September 2016, three corporate officers in two healthcare fraud and abuse cases settled allegations that they were personally liable for violations of federal fraud and abuse laws. These settlements come one year after...more

CFPB Watch: MSAs Going the Way of Arbitration Clauses?

MoFo Reenforcement on 10/9/2015

Following a now familiar approach, the CFPB issued a bulletin today that suggests deep disapproval of an entirely legal practice. This time, its target is marketing servicing agreements (MSAs), which are agreements that...more

Physicians Face Increased Anti-Kickback Enforcement Focus

Foley & Lardner LLP on 6/24/2015

It appears that the Office of Inspector General (“OIG”) now has physicians squarely in the crosshairs of one of its most powerful enforcement tools: the Anti-Kickback Statute (“AKS”). The AKS is a criminal statute with...more

OIG Warns Physicians of Potential Exposure for Unlawful Compensation Arrangements

McGuireWoods LLP on 6/10/2015

While the Department of Justice and the Department of Health and Human Services Office of Inspector General (OIG) have long scrutinized physician compensation arrangements, including medical director agreements, penalties...more

OIG Rejects Specialty Pharmacy Request to Pay “Per-Fill” Payents to Retail Pharmacies

Tucker Arensberg, P.C. on 8/27/2014

In OIG Advisory Opinion 14-06, the Office of Inspector General (OIG) concluded that payment by a specialty pharmacy to a retail pharmacy on a “per-fill” basis for services provided by the retail pharmacy could violate the...more

OIG Rejects Pharmacy’s Plan for Per-Fill Referral Fees, Or Be Careful What You Ask For

Faegre Drinker Biddle & Reath LLP on 8/26/2014

Advisory Opinion No. 14-06, issued August 15, addressed a plan by the chain to reimburse local pharmacies for referrals of patients in need of specialized drugs that the local pharmacies did not dispense. In the scenario...more

Advisory Opinion 14-01: OIG Says No AKS Sanctions for Senior Communities that Compensate Referral Source

Obermayer Rebmann Maxwell & Hippel LLP on 2/5/2014

In its first Advisory Opinion of 2014, the Department of Health and Human Services Office of Inspector General (“OIG”) found that an arrangement between a placement agency (the “Placement Agency”) and certain senior...more

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