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A proper understanding of the Anti-Kickback Statute (AKS) is completely necessary for healthcare providers and professionals. It is among the strongest weapons in the government arsenal for enforcing the federal fraud and abuse laws. Along with Stark II (the federal physician anti-referral law), the Anti-Kickback Statute can be and is being used as the basis for an action brought under the Federal False Claims Act.
Recently enacted healthcare laws such as the Affordable Care Act, and the enhancement of enforcement and health care fraud taskforces of late, have combined to greatly strengthen the government’s enforcement resources. The government can now take recourse to what is called “responsible corporate officer doctrine”, which allows it to pin the blame on hospital CEOs and others as being directly responsible for the fraud.
What happens when the provisions of the Anti-Kickback Statute are not implemented properly and thoroughly? Healthcare providers end up coughing huge amounts of money as penalties. Two recent related cases -The Christ Hospital case in Cincinnati, where settlement cost more than $100 million, and the Hardeman Memorial Hospital case in Texas, with a settlement of close to half a million dollars -serve as an indication of how severe the penalties for nonenforcement of the provisions of AKS can be.
Penalties can be in other forms, too. Take the instance of the same Hardeman case. The CEO, Angela Edwards, was awarded an imprisonment term of over two years, and was ordered to pay restitution of more than a third of a million dollars.
Complete learning of the AKS from the expert
In view of all these, does it need iteration that complete and thorough knowledge of the AKS and the ways of implementing it is an absolute must for healthcare professionals and providers?
This is the learning a webinar from MentorHealth, a leading provider of professional trainings in all the areas of healthcare, will be providing. Dr. William Mack Copeland, who is president of Executive & Managerial Development Group, a consulting entity that provides compliance and other fraud and abuse related services and is a frequent author and speaker on health law topics; will be the speaker at this webinar. To gain complete knowledge of how the provisions of the Anti-Kickback statute apply to healthcare professionals and providers; please enroll for this session.
The Anti-Kickback statute and its safe harbors
This webinar will explain how violation of the Anti-Kickback Statute (AKS) can raise False Claims Act concerns, and will provide an assessment of enforcement activities, showing how participants may be at risk. The speaker will discuss the “safe harbors”, payment practices that will not be subject to criminal prosecution and that will not provide a basis for civil monetary penalties or exclusion from the Medicare or Medicaid programs. In this section, Dr. Copeland will explain the more frequently used safe harbors to show how protection from enforcement can be achieved. In particular, he will take up matters relating to the investment, space and equipment rental, personal services/management contracts, and physician recruitment safe harbors for review.
The OIG's Joint Venture Advisory Opinion
Dr. Copeland will also discuss the OIG's Joint Venture Advisory Opinion concerning a hospital that expands into a related service line by contracting with an existing provider of that service. The OIG has reservations with such an arrangement. In addition, the recent advisory opinion by the OIG regarding Physician-Owned Entities will be taken up for discussion. About this aspect, this is the OIG’s viewpoint; PODs are inherently suspect under the AKS because the OIG considers the opportunity for a referring physician to earn a profit, including through an investment in an entity for which he or she generates business, as illegal remuneration under the AKS.
The speaker will present examples of various cases in which the courts have judged compliance with it. He will review recent cases and show how they potentially impact participants. He will also review the case law, particularly the early case law that sets the stage and basis for how the courts interpret the law.
Healthcare executives, physicians and other health care providers who participate in and receive remuneration from Medicare, Medicaid, and other federal health care programs such as TriCare will find this session highly useful. Dr. Copeland will cover the following areas at this webinar: