As the health care industry becomes more complex, so does compliance regarding the False Claims Act, Medicare Fraud, Medicare Abuse, Anti-Kickback Statute (AKS), Stark Law, and Criminal Health Care Fraud Statute.
Below is a brief summary as to how the Anti-Kickback Statute (AKS) may be defined and/or interpreted.
The AKS, 42 U.S.C. Section 1320a-7b(b), makes it a crime to knowingly and willfully offer, pay, solicit, or receive any remuneration directly or indirectly to induce or reward patient referrals or the generation of business involving any item or service reimbursable by a Federal health care program. When a provider offers, pays, solicits, or receives unlawful remuneration, the provider may violate the AKS.
NOTE: Remuneration includes anything of value, such as cash, free rent, expensive hotel stays and meals, and excessive compensation for medical directorships or consultancies.
Example: A provider receives cash or below-fair-market-value rent for medical office space in exchange for referrals.
The “safe harbor” regulations, 42 Code of Federal Regulations (C.F.R.) Section 1001.952, describe various payments and business practices that, although they potentially implicate the AKS, may not be treated as offenses under the AKS, if they meet certain requirements specified in the regulations. Individuals and entities remain responsible for complying with all other laws, regulations, and guidance that apply to their businesses.
Courtesy of CMS (2/19)
