A. During a recent Medicare conference, representatives of the Office of Inspector General announced that the healthcare industry should expect to see an uptick in the investigations of alleged Medicare fraud and abuse. True to their word, the OIG has been busy. As the new fiscal year approaches, now is a good time to review your agreements to confirm that they do not violate the federal anti-kickback statute (AKS) or applicable state laws.
Generally, the federal AKS prohibits suppliers and providers from paying (or offering to pay) someone else to send them federal healthcare business because that may violate the AKS. Payment is not limited to cash, but rather can be anything of value, including use of office space, marketing, etc. Parties on both sides of the transaction face liability under the AKS. Violation of the law is a felony, punishable with up to five years in prison, a $25,000 fine, exclusion from Medicare and Medicaid, and license revocation. AKS liability may also trigger liability under the False Claims Act for claims stemming from the prohibited activity.
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