sample solution

The Anti-Kickback Statute (42 U.S.C § 1320a-7b) is a federal law that prohibits offering or paying anything of value to induce referrals for services covered by Medicare and Medicaid, or other federally funded programs (Inspector General FACT SHEET on Anti-Kickback Law, n.d.). The statute was established in an effort to protect patients from healthcare providers who may seek to benefit financially from their recommendation of particular products or services (Inspector General FACT SHEET on Anti-Kickback Law, n.d.).

The Stark Law (42 U.S.C § 1395nn) also known as the Physician Self-Referral Law is a federal law which prohibits physicians from referring Medicare patients for designated health services payable by Medicare to entities with whom they have a financial relationship (ASHA Summary of Self-Referral and Anti-Kickback Regulations, 2017). This law was implemented in order to prevent physicians from making decisions based solely on potential monetary gain rather than the best interests of their patients—enabling them instead to make unbiased recommendations based solely on patient need and medical appropriateness (ASHA Summary of Self-Referral and Anti-Kickback Regulations, 2017).

Violation of these two statutes can result in significant criminal and civil penalties including exclusion from participating in any Federal healthcare program, fines up to $50K per violation plus three times the amount claimed for each false claim submitted (Department of Justice Office Of Inspector General Fraud Alerts & Advisories: Compliance Guidance For Pharmaceutical Manufacturers 2016). To ensure compliance with these laws it important for healthcare professionals to understand not only what constitutes illegal behavior under the anti kick back statutes but also how certain arrangements can be structured so as not run afoul of either one These legal requirements provide incentives for ethical practices when referring patients or providing payments among different parties within the healthcare system (Department of Justice Office Of Inspector General Fraud Alerts & Advisories: Compliance Guidance For Pharmaceutical Manufacturers 2016).References
ASHA Summary Of Self Referral And Anti Kick Back Regulations.[2017]. Retrieved December 18 2020 From Https://www.asha.org/uploadedFiles/Interpretation%20Stark%20Law%20for%20Professionals.(pdf)
Department Of Justice Office Of Inspector General Fraud Alerts & Advisories:Compliance Guidance For Pharmaceutical Manufacturers [2016].Retrieved December 18 2020 From https://oig.hhs.gov/compliance/pharmaceutical/files//AlertFraudAdvisoryPharmaManufacturerComplianceGuidances508c(1).pdf
Inspector General Fact Sheet On Anti KickBack Law[nD].Retrieved December 18 2020 From https://oig.hhs.gov/fraud/docs/kickbacksundayfinalversionupdate2jan08slideset3part1revoke17dec09[1]715ab6b857195e54dfdfc88409e7770f938c53bd9ee60a3402541fdce356be6e99ef2cdad8054ae426116eb90f0bbcb4

This question has been answered.

Get Answer
WeCreativez WhatsApp Support
Our customer support team is here to answer your questions. Ask us anything!
👋 WhatsApp Us Now