Question: What Is The Difference Between The Stark Law And The Anti Kickback Statute?

What are the goals of the Anti Kickback Statute?

FEDERAL ANTI-KICKBACK LAW AND REGULATORY SAFE HARBORS.

Overview: On the books since 1972, the federal anti-kickback law’s main purpose is to protect patients and the federal health care programs from fraud and abuse by curtailing the corrupting influence of money on health care decisions..

What is considered a kickback in healthcare?

Kickbacks are arrangements made between providers in which one party refers patients to another through services, goods or medicines. … In this hypothetical, the physician is giving out medicine not to treat their patient’s condition, but because they are receiving payments from the company that makes the drug.

What is a safe harbor under the Stark Act?

The safe harbor regulations define payment and business practices that will not be considered kickbacks, bribes, or rebates that unlawfully induce payment by Medicare or Medicaid programs. The regulations specify allowable financial and referral relationships between physicians or other providers and suppliers.

Do Stark laws apply to employed physicians?

Both the Stark Law and the Anti-Kickback Statute contemplate employment of physicians by hospitals, and accordingly, both include an exception to accommodate the compensation paid by a hospital employer to a physician employee.

Does Stark law apply to pharmacies?

The Stark Law applies to all relationships that physicians have with designated health services entities, and pharmacies are classified as such. Because of this, referral relationships between physicians and pharmacists can be scrutinized through the lens of the Stark Law.

What is an example of the Anti Kickback Statute?

The Anti-Kickback Statute The illegal kickbacks can be cash payments, but often include other items of monetary value, such as gifts, free or discounted supplies or services, and travel. … For example, they might pay doctors inflated rates for speaking engagements or pay above fair market value to lease office space.

Who does Stark Law apply to?

The Stark statute applies only to physicians who refer Medicare and Medicaid patients for designated health services to entities with which they (or an immediate family member) have a financial relationship. There are almost 20 exceptions to the Stark statute.

What is the purpose of Stark law?

The Stark Law is a healthcare fraud and abuse law that prohibits physicians from referring patients for certain designated health services paid for by Medicare to any entity in which they have a “financial relationship.” The federal government interprets the term “financial relationship” broadly to include any direct …

What is considered a kickback?

A kickback is an illegal payment intended as compensation for preferential treatment or any other type of improper services received. The kickback may be money, a gift, credit, or anything of value. … Kickbacks are often referred to as a type of bribery.

How do you prevent anti kickback statute?

Five Tips For Anti-Kickback ComplianceBe aware of several safe harbors to the federal anti-kickback statute. … Implement and follow a compliance program for your practice. … Educate yourself about the risks. … Ask yourself whether certain gifts are legitimate. … Develop standards and procedures to address arrangements with other healthcare providers and suppliers.

What are the exceptions to the Stark law?

Vaccines, immunizations, and screening tests are generally allowable Stark exceptions provided they aren’t given too often. The tests must be covered by Medicare. Intra-family rural referrals. Additionally, some referrals in rural areas are allowed if the services are for an immediate family member.

What is stark and anti kickback law?

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 …

What is prohibited by the Anti Kickback Statute?

The AKS is a criminal law that prohibits the knowing and willful payment of “remuneration” to induce or reward patient referrals or the generation of business involving any item or service payable by the Federal health care programs (e.g., drugs, supplies, or health care services for Medicare or Medicaid patients).

Does Anti Kickback Statute apply to private insurance?

In October of 2018 Congress enacted a new law that applies to many commercial health insurance plans, as well as Medicare and Medicaid. Unfortunately, these provisions create expansive anti-kickback penalties for all private and commercial pay business. …

What is the beneficiary inducement statute?

The federal Beneficiary Inducement Statute (“BIS”) prohibits an individual or entity from providing remuneration to patients who are eligible for Medicare or Medicaid benefits if that individual or entity knows (or should know) that doing so is likely to influence the patient’s decision to order or receive items or …