decisionhealth Newsletters, Answer Books - 2009 Issue 2 (February)
Compliance / Reverse kickbacks
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Article Overview
This article explains a compliance issue involving alleged reverse kickbacks in health care business arrangements, especially in ambulatory surgery center and anesthesiology settings. It discusses the Anti-Kickback Statute, the role of intent, and the kinds of business pressures and payment demands that may raise concern. The piece is aimed at readers who need a broad understanding of fraud-and-abuse risk in facility contracting and referral-related arrangements.
Why This Topic Matters
These arrangements can create fraud-and-abuse exposure for physicians, group practices, and facility owners when compensation, services, or costs are tied to referrals or continued access to a facility. Understanding the compliance concerns helps practices recognize potential risk and evaluate whether a business arrangement may warrant closer review.
What You Will Learn
- How reverse kickback concerns arise in health care business relationships
- Why intent matters in Anti-Kickback Statute analysis
- Common types of facility-related arrangements that can trigger compliance concern
- How business context can affect whether an arrangement appears problematic
Who Should Read This
- Physicians
- Anesthesiology practices
- Pain management practices
- Ambulatory surgery center administrators
- Compliance professionals
- Medical practice managers
Codes Discussed
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