decisionhealth Newsletters, Answer Books - 2009 Issue 4 (April)
Anti-Kickback Statute / Illegal remuneration / Remuneration to induce referrals
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Article Overview
This premium article addresses the federal Anti-Kickback Statute and the broader issue of illegal remuneration used to influence referrals. It is relevant to compliance, billing, legal, and health care administration audiences that need to understand how referral-related compensation arrangements can raise fraud-and-abuse concerns and what kinds of penalties may apply. The article also includes an illustrative enforcement example showing how improper payments and benefits were treated in a provider-referral setting.
Why This Topic Matters
Referral-related compensation arrangements can create significant legal and compliance risk for providers, hospitals, vendors, and health care organizations. Understanding the statute, enforcement posture, and potential penalties helps organizations evaluate arrangements that could affect Medicare and other federal health care program participation.
What You Will Learn
- The general scope of the federal Anti-Kickback Statute
- How illegal remuneration concerns arise in referral-related arrangements
- What types of penalties and exclusions may follow enforcement actions
- Why undisclosed compensation relationships can create compliance risk
- How an enforcement example illustrates referral-related misconduct
Who Should Read This
- Health care compliance professionals
- Medical coders
- Billing and reimbursement staff
- Health care attorneys
- Hospital administrators
- Physician practice managers
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