What is the Anti Kickback rule?
The Anti-Kickback Statute and Stark Law prohibit medical providers from paying or receiving kickbacks, remuneration, or anything of value in exchange for referrals of patients who will receive treatment paid for by government healthcare programs such as Medicare and Medicaid, and from entering into certain kinds of …
What is stark and anti kickback law?
§ 1320a-7b.) is a criminal statute that prohibits the exchange (or offer to exchange), of anything of value, in an effort to induce (or reward) the referral of business reimbursable by federal health care programs. …
What is prohibited by the Anti Kickback Statute?
The AKS is a criminal law that prohibits the knowing and willful payment of “remuneration” to induce or reward patient referrals or the generation of business involving any item or service payable by the Federal health care programs (e.g., drugs, supplies, or health care services for Medicare or Medicaid patients).
What are the goals of the Anti Kickback Statute?
FEDERAL ANTI-KICKBACK LAW AND REGULATORY SAFE HARBORS. Overview: On the books since 1972, the federal anti-kickback law’s main purpose is to protect patients and the federal health care programs from fraud and abuse by curtailing the corrupting influence of money on health care decisions.
What is the difference between Stark and Anti Kickback?
The AKS prohibits referrals for any kind of item or service where a kickback is involved, while the Stark Law prohibits only the referral of designated health services where a financial interest is involved.
What is an example of a kickback?
The definition of a kickback is slang for a bribe or incentive paid to someone who helped you make money, or a sudden, forceful recoil. When you bid on a job and job is awarded to you and you have to pay someone $1000 because your received the award, this $1000 payment is an example of a kickback.
Who does Stark Law apply to?
The Stark statute applies only to physicians who refer Medicare and Medicaid patients for designated health services to entities with which they (or an immediate family member) have a financial relationship. There are almost 20 exceptions to the Stark statute.
What is the Stark II law?
1,2. Stark II prohibits a physician or immediate family member who has a direct or indirect financial relationship with an entity from making referrals to that entity to provide designated health services (DHS) payable by Medicare or Medicaid, unless an exception applies.
How do you prevent anti kickback statute?
Five Tips For Anti-Kickback Compliance
- Be aware of several safe harbors to the federal anti-kickback statute. …
- Implement and follow a compliance program for your practice. …
- Educate yourself about the risks. …
- Ask yourself whether certain gifts are legitimate. …
- Develop standards and procedures to address arrangements with other healthcare providers and suppliers.
What is an illegal provider relationship?
Yes and No. The Stark law prohibits a physician with a financial relationship in an entity from making a referral for designated health services covered by Medicare and Medicaid to that entity even if the services are billed to an individual or other third party payer.
Does Anti Kickback Statute apply to private insurance?
Currently, the Anti-Kickback Statute (“Federal AKS”) only applies to Federal health care programs. … The first entity might be for Federal health care business (Medicare and Medicaid) while the second entity might be for private pay health care business (commercial insurance and cash).
Who enforces anti kickback statute?
Office of the Inspector General
What is a kickback in healthcare?
Posted August 29th, 2017 by Inayat Hemani in Whistleblower Law. We all have a general idea of what a kickback, or a bribe, looks like. … The Anti-Kickback Statute (“AKS”) is a federal law that prohibits paying or receiving remuneration in order to induce the referral of government paid healthcare business.
What is a kickback?
A kickback is an illegal payment intended as compensation for preferential treatment or any other type of improper services received. The kickback may be money, a gift, credit, or anything of value.