The Department of Justice recently announced criminal charges against an internist out of Long Island for healthcare fraud. The physician has decades of experience in his profession, but the government claimed he was using improper practices to refer patients for additional medical testing. According to the prosecution, the physician would refer patients for medically unnecessary tests in exchange for a $100 kickback.
An allegation of healthcare law violations can have serious ramifications for medical professionals, particularly doctors. These accusations can arise from ordering medically unnecessary services, such as in the case noted above. Doctors are wise to learn from this case, especially when looking to refer costly diagnostic tests like brain scans and make sure such decisions are based solely on medical necessity and patient care standards.
What are the possible penalties for AKS violations?
Healthcare fraud charges may include allegations of violating the federal Antikickback Statute (AKS). The legal consequences of violating this law are severe and can include:
- Criminal penalties: These may involve fines and imprisonment, reflecting the seriousness of the offense.
- Civil penalties: Doctors may face fines and be excluded from participating in federal health care programs, which could be career-ending.
Understanding these penalties underscores the importance of adhering to federal regulations like the AKS and ensuring that all medical decisions are legal.
How can doctors defend themselves against these allegations?
Doctors are wise to maintain thorough medical records. This can provide important evidence to help establish the medical necessity of tests. It is also helpful to demonstrate decisions were made independently of any external financial influences can help counteract allegations of impropriety.
These strategies can help build the foundation for a defense against false accusations and protect one’s professional integrity. It is important to discuss these and other options with an attorney experienced in this niche area of healthcare law.
Attorney John Rivas is responsible for this communication.
