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Anti-Kickback Statue

Under the Anti-Kickback Statue, it is illegal for any health care provider to, “knowingly and willfully offer or pay any remuneration (including kickbacks, bribes, or rebates) directly or indirectly, overtly or covertly, in cash or in kind to any person to induce”, a patient referral - where any part of the payment is to be made using funds from a federal health care benefit program. Federal law makes it a punishable offense to receive any such kickback or bribe as well.

These may include:

  • Cash payments.
  • Discounts for services, supplies, or equipment.
  • Free or below fair market value use of clinical space, equipment or staff.
  • Cash payments.
  • Discounts for services, supplies, or equipment.
  • Free or below fair market value use of clinical space, equipment or staff.

While the Anti-Kickback Statue applies broadly to providers in all segments of the health industry that participate in federal programs like Medicare, the Stark Law prohibits any transaction that qualifies as a so-called “physician self-referral”, which is defined as a referral for health services to be provided by an entity with which the referring physician has a “financial relationship”.

The definitions of “designated health services” and “financial relationship” are both extremely broad, and this makes Stark a dangerous weapon used by authorities seeking to crack down and put pressure on physicians.

Designated health services include:

  • Clinical laboratories
  • DME supplies
  • Home health services
  • Imaging
  • Hospital services
  • Outpatient pathology and prescriptions
  • Physical therapy
  • Prosthetics
  • Radiology

Compensation can be direct or indirect. There are several exceptions to Stark Law under certain circumstance. Having correct documentation is the best way to avoid liability.