What is the Anti-Kickback Statute?

If you provide health care services for which you may receive payment from Tricare, Medicaid, Medicare or any other federal program, you need to be aware of the Anti-Kickback Statute. The AKS is a federal law enacted in 1986. It prohibits remuneration in exchange for referrals for which the federal government will be picking up the tab.

With few exceptions, you cannot accept anything of value in exchange for a referral, nor can you ask for remuneration in exchange. According to Physician Practice, examples of gifts or offerings that would violate the Anti-Kickback Statute include travel expenses, free meals and tangible gifts, such as electronics or tickets to a live event. The AKS also prohibits rebates or bribes in the form of cash money.

Violations of the Anti-Kickback Statute can result in felony charges. The law applies not only to doctors who accept remuneration but also to the party who pays it. The possible consequences if convicted include a $25,000 fine and a prison term of up to five years.

However, it is possible that you could face criminal charges apart from violations of the Anti-Kickback Statute but related to the same incident. Depending on how you received the payment, there could be charges of mail fraud or wire fraud. If convicted on multiple charges, your imprisonment could last more than five years. There could also be civil penalties beyond the fine if the alleged AKS violation also ran afoul of the False Claims Act.

The Anti-Kickback Statute contains provisions for certain conduct called “safe harbors” that do not violate the law. Unfortunately, however, the safe harbors contain many gray areas, and you may accidentally engage in conduct that goes beyond what the AKS allows.

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