Many cases of healthcare fraud that involve Medicare, Medicaid, and other healthcare agencies involve kickbacks. A common kickback example is when drug makers pay physicians financial compensation to recommend the drug makers’ drugs to their patients. Another example is when hospitals provide doctors with free services in return for the understanding that the doctors will refer patients to their hospitals and not to other hospitals. Kickbacks also include informing patients that they don’t have to pay the copays on insurance if they use the doctor’s services.
The federal law that regulates kickbacks in the healthcare sector is called the Anti-Kickback Statute (AKS). It is a criminal law the precludes payments to induce others to refer to business. The Anti-Kickback Statute has numerous definitions that cover what types of remuneration are forbidden and what types of referrals are illegal.
A whistleblower who discovers that some company or person has given a kickback for medical supplies, devices, drugs, or medical services can usually also bring a qui tam action through the False Claims Act. The Department of Justice can then proceed against the wrongdoers on two fronts – the violation of the False Claims Act for fraud and the violation of the Anti-Kickback Statute for the kickbacks. The fundamental essence of the AKS law is that doctors should do what is best for their patients who receive government benefits such as Medicare and not for their wallets or pocketbooks.
The allow applies to both the person paying the kickback and to the person receiving the kickback.
There are safe harbors set forth in the Anti-Kickback Statute. These safe harbors allow health care vendors and practitioners the right to give certain prescribed inducements in order to obtain business.
An inducement is generally anything of value. It includes more than just cash or a check. It can include free meals, free products, payments for speeches that are excessive, free rent or discounted rent, donations to a doctor’s favorite charity, paying for sexual companionship, and other incentives.
Many employees and contractors who do the marketing or sales for health companies may become award of a kickback scheme. Company executives may also become aware of kickback violations. These people should immediately speak with experienced California whistleblower lawyers who can explain what steps to take to protect their claim. The lawyers at Stephen Danz & Associates have been fighting for whistleblowers and helping them get their just rewards for disclosures – for several decades. To learn if you have a valid whistleblower claim, call (877)789-9707 today. Se Habla Espanol.