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Anti-Kickback Laws

Kickback

Federal law prohibits accepting or offering rewards in exchange for referring certain products or services. There are, however, a variety of exceptions to this rule, so if you are being investigated for taking or offering kickbacks, it is critical to speak with an experienced white collar crime attorney who can protect your interests and explain your legal options.

Federal Law

It is a violation of federal law for anyone to knowingly request, receive, offer, or pay a reward for referrals or for generating federal health care business. This law applies to both direct and indirect solicitations as well as transactions made in cash and those made in kind.

Exceptions

The Anti-Kickback statute does not apply to any of the following exceptions:

  • A discount or other reduction in price obtained by a federal health care program services provider if the reduction is appropriately disclosed;
  • Any amount paid by an employer to a worker;
  • A waiver of coinsurance by a federally qualified health care center to someone who qualifies for subsidized services;
  • Any payment between an organization and a person or entity providing items or services in accordance with a written agreement as long as the agreement places the individual or entity at substantial financial risk for the cost of the items;
  • Any payment between a federally qualified health center and any person who provides goods, services, loans, or donations to it in accordance with a contract, lease, grant, or loan if the agreement contributes to the ability of the health center to maintain or increase the availability of or enhance the quality of services provided to an underserved population; and
  • A discount in the price of a drug that is given to a beneficiary under the Medicare coverage gap discount program.

Finally, a payment is not considered a kickback if it is paid by a vendor of goods or services to someone authorized to act as a purchasing agent for a group of individuals if:

  • The person has a written contract, which specifies the amount to be paid to each person, and
  • The person discloses the amount received from each vendor concerning the purchases made by or on behalf of the entity.

A person who is convicted of accepting or paying kickbacks faces imprisonment of up to five years and a fine of $25,000. Conviction also results in mandatory exclusion from participation in any federal health care program as well as the assessment of civil monetary penalties.

Safe Harbors

The U.S. Department of Health & Human Services Office of Inspector General (OIG) is permitted to adopt certain safe harbors that protect specifically identified business and financial practices form prosecution as long as they satisfy the necessary requirements. Whether a transaction violates the Anti-Kickback statute is decided on a case by case basis by the OIG.

Contact an Experienced White Collar Crime Attorney

Please contact the legal team of Jeffrey S. Weiner, P.A.by calling 305-670-9919 to learn more about violations of the Anti-Kickback statute. Our South Florida attorneys are prepared to assist you today.

Resources:

law.cornell.edu/uscode/text/42/1320a-7b

law.cornell.edu/uscode/text/42/1320a-7

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