According to the Anti-Kickback Statute 42 US Code Section 1320A-7B(B), it is prohibited to knowingly and willfully offer, solicit, pay, or receive anything of value which create any type of reward for referring patients to, recommending or arranging any type of purchase that falls under the payment made by health care benefit programs.
The statute covers both the payers of kickbacks-those who pay or offer remuneration and the recipients of kickbacks-those who receive or solicit remuneration.
Illegal remuneration includes anything of value and can take many forms besides cash, such as:
There are safe harbor regulations that protect certain payment and business practices that could otherwise implicate the Anti-Kickback Statute from criminal and civil prosecution. The safe harbor regulations put definitions of these practices to make them lawful for medical providers. The regulations must be exactly met with no exceptions to qualify for safe harbor protection.
Though the Anti-Kickback Statute is a criminal statute, it provides both civil and criminal penalties for violations.
The criminal penalties are the following:
Additionally, the Office of the Inspector General for the Department of Health and Human Services can pursue:
Sometimes penalties for Anti-Kickback violations also include a period of debarment or exclusion from participation in Medicaid, Medicare, and all other federal programs which provide health benefits.
Anti-Kickback Statute the Stark Law are the two main federal statutes that deal with remuneration related to improper referrals. Though the two laws are similar, there are several differences between the Stark Law and the Anti-Kickback Statute.
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