Helping Providers Follow Federal Anti-Kickback Laws
As a heavily regulated industry, the health care profession is subject to a complex set of federal laws. Two of these laws are the Stark Law and the Anti-Kickback Statute. Simply stated, under the Stark Law, a physician may not refer a Medicare or Medicaid patient to a health care provider for designated health services if the referring physician or a member of his or her immediate family has a financial or ownership relationship with the other provider. The Anti-Kickback Statute prohibits referrals for Medicare services in exchange for any compensation or remuneration.
Rivas Goldstein, LLP, is a New York City law firm focused on representing medical professionals and health care providers. We are deeply familiar with the Stark Law and the Anti-Kickback Statute and routinely provide analysis and legal opinions on whether a specific arrangement is compliant with these laws. Our health care lawyers are dedicated to helping medical professionals protect themselves and their careers.
What Is The Difference Between The Stark Law And The Anti-Kickback Statute?
The most crucial difference between these two laws is that the Anti-Kickback Statute is a criminal law and the Stark Law is a civil statute. The Anti-Kickback Statute requires proof beyond a reasonable doubt. In contrast, the Stark Law merely requires proof by a preponderance of the evidence. Furthermore, the Stark Law only applies to physicians, while the Anti-Kickback Statute applies to all individuals receiving Medicare and Medicaid. Also, the Stark Law is a strict liability statute, meaning that even if you had no knowledge that you were in violation, you would be held accountable.
Exceptions To The Stark Law And Safe Harbors To The Anti-Kickback Statute
There are numerous exceptions to the Stark Law and safe harbors within the Anti-Kickback Statute. Before entering into any designated health care transaction or referral, it is critical to determine whether any of the available exceptions or safe harbors apply. These include:
- Referrals to physicians in the same medical group
- Transactions for in-office ancillary services
- Referrals within prepaid health plans
- Lease agreements
- Personal service agreements
- Bona fide employees
- Small entity investment “60/40”
What Our Firm Does To Help
Rivas Goldstein, LLP, is well-positioned to defend allegations involving violations of the Stark Law and the Anti-Kickback Statute. Our health care law attorneys are experienced in negotiating with federal regulators for reduced penalties, and we work to help clients avoid criminal prosecution. Ideally, clients will seek our services before referring a patient, which allows us to determine whether a Stark Law exception applies.
We also can help you avoid any noncompliance by ensuring that your arrangement does not violate the law. Given that the penalties for a Stark Law violation can be as much as $15,000 per violation and an Anti-Kickback violation up to $25,000 per instance and prison, we recommend ensuring your arrangement is compliant before you begin operating.