Stark and Anti‐Kickback Compliance Frank Sheeder Partner, Alston & Bird Frank.Sheeder@Alston.com 2 What We Will Cover Stark Law Primer Anti‐Kickback Summary Common Pitfalls Some unfortunate cases Board and leader oversight. 2/14/2019 2 3 Stark Law Background

Practice Fusion to overhaul compliance after $145M kickback resolution. 2020-02-05T16:37:00Z. Practice Fusion will pay a total of $145 million to resolve criminal and civil investigations for its leading role in an opioid kickback scheme.

The FCPA tells us that. It is even more complicated when trying to navigate Anti-Kickback and Stark law violations. Doctors like to make money. As the government expands its role in our healthcare system, doctors have to be even more mindful of compliance when it comes to earning Medicare and Medicaid fees. Federal anti-kickback law: The Federal anti-kickback law provides criminal penalties for individuals and entities that knowingly offer, pay, solicit or receive bribes, kickbacks, rebates or other remuneration in order to induce or reward business that is reimbursable, in whole or in part, under a Federal health care program (including Medicare and Medicaid). Kickback-Zahlungen sind Provisionsrückvergütungen, die im Rahmen einer Geschäftsbeziehung an einen Dritten fließen.

Compliance Assistance Available The Department of Labor provides employers, workers, and others with clear and easy-to-access information and assistance on how to comply with the Copeland “Anti-Kickback” Act. Compliance with safe harbors is voluntary, and arrangements that do not comply with a safe harbor must be analyzed on a case-by-case basis for compliance with the anti-kickback statute. Parties who are uncertain whether their arrangements qualify for safe harbor protection may request an advisory opinion. The new and amended regulations related to the federal Anti-Kickback statute and the civil monetary penalties law issued by OIG address stakeholder concerns that these laws unnecessarily limit the ways in which healthcare providers can coordinate care with and for federal healthcare program beneficiaries. Anti-kickback, Stark, HIPAA, and Information Blocking Rule Whether you work at a hospital or own your own practice, it is vital that you establish a compliance program designed to help you avoid Anti-Kickback Statute, Section 1128B(b) of SS Act, 42 USC 1320a7-b(b) One-Purpose Test (Majority in case law) Ascribes criminal liability to both sides of an impermissible “kickback” transaction, and has been interpreted to apply to any arrangement where even one purpose of the remuneration offered, paid, received, etc., is The Anti-Kickback Statute and Stark Law prohibit medical providers from paying or receiving kickbacks, remuneration, or anything of value in exchange for referrals of patients who will receive treatment paid for by government healthcare programs such as Medicare and Medicaid, and from entering into certain kinds of financial relationships. The kickback prohibition applies to all sources of referrals, even patients. For example, where the Medicare and Medicaid programs require patients to pay copays for services, you are generally required to collect that money from your patients. UW MEDICINE │HCAA 2013 Compliance Institute HCCA 2013 COMPLIANCE INSTITUTE ANTI-KICKBACK STATUTE 101 April 23, 2013 Robert S. Brown Senior Compliance Specialist UW Medicine Compliance SEATTLE, WASHINGTON 2 SEATTLE, WASHINGTON 3 Provident Management Consulting’s (“Provident”) Physician & Vendor Arrangements solution helps build the policy and organizational structure needed to comply with Stark and Anti-Kickback Statute requirements.

Then HSS OIG released another Final Rule amending various safe harbors to the Federal Anti-Kickback Statute. The changes appear to be based, in large part,

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the Anti-kickback Statute. Compliance with safe harbors is voluntary. Therefore, failure to satisfy the applicable safe harbor(s) does not mean that an arrangement is necessarily illegal, but rather that it may be subject to scrutiny and prosecution under the Anti-kickback Statute.7 Some of the more significant safe harbors

Although this chapter focuses on hospital remuneration ﬂowing to physicians, another aspect of hospital-physician ﬁnancial relationships that warrants compliance attention under the anti–kickback statute—the ﬂow Start studying Compliance - Anti-Kickback Statute. Learn vocabulary, terms, and more with flashcards, games, and other study tools. When an anonymous e-mail reached senior executives at National Steel Corporation (NSC), its charges were explosive: an NSC executive vice president had extorted millions in kickbacks from a scrap-iron vendor, which in turn had overbilled NSC $1 million to $3 million annually for seven years.

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» Possible many device companies will be subject to CIAs in future » Trickle-down kickback compliance for customers. If industry says “no,” then kickback avoided. » Unlikely prosecution of solicitation only kickbacks o Inevitably restricting payments by organizations subject to … (including any kickback, bribe or rebat e) directly or indirectly, overtly or covertly, in cash or in kind to any person to induce such person: • to refer an individual to a person for the furnishing or arranging for the furnishing of any item or service for which payment may be made in whole or in part under a Federal health care program, or Practice Fusion to overhaul compliance after $145M kickback resolution. 2020-02-05T16:37:00Z. Practice Fusion will pay a total of $145 million to resolve criminal and civil investigations for its leading role in an opioid kickback scheme.

4.1. Compliance with the Anti-Kickback Statute and Stark Law is a required condition of employment or continued engagement with Millennium.
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Strategic Management Services, LLC | July 2018. Health care organizations are required to comply with a long list of federal and state laws that are meant to help prevent instances of fraud, waste, abuse and other unethical behavior or actions in the health care industry. Two of these laws include the Stark Law and the Anti-Kickback Statute (AKS).

Healing people through healthcare and compliance. Examine the Anti-Kickback Statute (AKS) and determine whether your practice is in violation. The announcements confirm settlements for violations of the Stark Law, a federal anti-self-referral law and the Anti-Kickback Statute (AKS). The purpose of Stark Law is to ensure that patients will receive medical advice and will treat with physicians based on their medical needs and not on what profits the doctors or medical practices involved.