Tag: Anti-Kickback Statute

WASHINGTON - CMS has finalized a number of changes to the Stark Law, including new permanent exemptions for value-based arrangements, in a 627-page final rule set to be published in the Federal Register on Dec. 2. The exemptions will allow physicians and other health care providers to design and enter into value-based arrangements without fear that legitimate activities to coordinate and improve the quality of care for patients and lower costs would violate the physician self-referral law, CMS says....

WASHINGTON - The Department of Health and Human Services has proposed changes to the Stark Law that would, among other things, create new exceptions that recognize incentives are different in healthcare systems that pay for value- vs. volume-based care.The proposal includes proper safeguards that ensure the Stark Law will continue to provide meaningful protection against overutilization and other harms, while giving physicians and other healthcare providers added flexibility to improve the quality...

CLEARWATER, Fla. - Lincare has paid $5.25 million to resolve allegations that it violated the federal False Claims Act and the Anti-Kickback Statute by offering illegal price reductions to Medicare beneficiaries, according to the U.S. Attorney's Office for the Southern District of Illinois. The government alleged that, from 2011 to 2017, Lincare attempted to gain a competitive advantage in the market by unlawfully waiving or reducing co-insurance, co-payments and deductibles for beneficiaries who...

A.  There is a good chance the prescription issued will not be valid, and the payment for the telehealth encounter could be problematic under an anti-kickback statute.      In order for a prescribing practitioner, such as a physician, physician assistant, or nurse practitioner, to issue a valid prescription, the practitioner must first establish a practitioner-patient relationship. Most states now allow a practitioner to establish this relationship by way of a telehealth...

A.  Yes, but the appropriate payment terms will depend on the nature of the leads.When reviewing any lead generation arrangement, a key regulatory issue is whether the arrangement complies with the federal Anti-Kickback Statute (AKS). The AKS prohibits a person from soliciting, receiving, offering, or paying anything of value in return for, or in order to induce referrals or the arrangement of referrals of individuals covered by a federal health care program (FHCP).In light of this, a threshold...

MURRYSVILLE, Pa. - Philips Respironics has agreed to pay $34.8 million to resolve alleged False Claims Act violations for paying kickbacks to DME providers that bought its CPAP masks, the Department of Justice has announced.The government alleges that from April 2012 to November 2015 Respironics waved the per-patient per-month fee for its medSage automated resupply services for DME providers that bought the company's masks. If they used a competitor's masks, the company charged a fee.“The payment...