Allegations of kickback violations can lead to more than just harsh civil penalties, they can also lead to criminal charges. That was the case when the government accused a national hospital chain of various forms of healthcare fraud, including kickback violations.
The federal government continues its crackdown on alleged illegal kickback violations with a recent investigation of drug manufacturers. The investigations focused on services to doctors including the provision of nurses and reimbursement assistance.
The law is always evolving. This is true whether discussing tax law, family law or the laws that impact health care. The tax code, for example, was the subject of the largest overhaul in recent history with the passage of the Tax Cuts and Jobs Act at the end of 2017.
The government recently convicted two brothers of conspiracy to bribe doctors and money laundering crimes. The prosecution stated the brothers used a lab designed to provide medical tests for physicians to commit a complicated scheme. The brothers would provide physicians with kickbacks in the form of cash in exchange for the physicians sending blood samples to their labs for testing. The brothers also admitted to providing fancy meals and private jet trips to the large majority of physicians that used their lab for services.
One of the pillars of the medical industry is that the professionals that work in it are unbiased and unaffected by outside influences, especially when it comes to prescribing drugs and medicine or referring patients to other facilities and medical institutions. This is important for obvious reasons, but even well-meaning medical professionals can run afoul of the laws that relate to compliance without even realizing it.
The United States Department of Justice (DOJ) appears to be increasing enforcement efforts regarding violations of the Stark Law and the Anti-Kickback Statute (AKS). These efforts were highlighted in a recent case involving two urologists accused of submitting improper claims. The physicians agreed to pay $1 million to resolve the matter.
A New York science and technology news publication is reporting that a jury recently found the former CEO of a diagnostic testing lab and two marketing executives liable for Medicare fraud under the federal False Claims Act.
Negative publicity began to swirl around now-shuttered Health Management Associates back in 2012 when news magazine "60 Minutes" aired a segment alleging that the hospital chain pressured emergency room doctors to admit patients whether they needed care or not. The pressure on HMA escalated two years later when the New York Times reported that the company inflated its Medicare and Medicaid payments by pressuring physicians to admit at least half of patients age 65 and above.
It is about a 10-hour drive from the densely packed, bustling streets of New York City to the wide open, quiet cornfields and farms of Indiana. The pace of life and the cultures of the two places are worlds apart, but we are also linked by factors common to us both.
The Stark law was named for its co-sponsor, Congressman Pete Stark, but it may as well have been named for its stark treatment of physicians who violate its regulations. The Stark law is considered a strict liability law—that means that anyone who violates it can be penalized, even if they had no intention of committing a violation. Ignorance of the law isn't an excuse, either. A physician who had no knowledge of committing an infraction may still face the penalties.