Anti-Kickback Statute Violations

The federal Anti-Kickback Statute helps the government combat fraud that costs Michigan taxpayers millions of dollars. Given the potential consequences of a conviction, it is crucial for those who are facing allegations of kickback violations to understand the applicable laws and possible strategies for handling an investigation or fighting any charges that may be filed against them.

A Michigan Anti-Kickback Statute violations lawyer can help in several ways. When you work with a seasoned healthcare fraud attorney who is familiar with the prosecution of alleged kickback situations, you could gain an ally who may be able to provide advice and representation throughout the process to help reach a positive outcome.

The federal Anti-Kickback Statute (AKS) is part of anti-fraud provisions in healthcare law codified in 42 U.S.C. 1320a-7b. Designed to help prevent inflated costs or unnecessary referrals, the statute forbids payment of "remuneration" to reward or induce referrals or business that involves services paid for by federal health care programs. This includes items such as supplies and drugs, or actual services provided to patients in Medicare, Medicaid, and other federal programs.

The remuneration prohibited under the law specifically includes "kickbacks, bribes or rebates." Such remuneration also refers to both monetary payments and in-kind benefits. This could consist of free rent, luxury accommodations, and entertainment. Critically, it is just as illegal to seek or accept health care kickbacks as it is to offer or pay a kickback, bribe, or rebate. Individuals who were accused of Anti-Kickback Statute violations should speak with an experienced Michigan attorney to learn their options.

Since the provisions of the Anti-Kickback Statute are broadly phrased, they nominally prohibit many practices which are actually beneficial and accepted by the medical industry and the government. Accordingly, federal law includes several exceptions that allow for these practices to continue. Many of these are known as "safe harbors" because they provide immunity from enforcement of anti-kickback provisions.

As an example, 42 C.F.R. §1001.952 specifies that prohibited remuneration does not include payments made for rent of space. It should be noted that the situation must satisfy six specific criteria to meet this safe harbor provision.

Those found guilty of violating the Anti-Kickback Statute face the potential for both criminal and civil penalties, and administrative sanctions. Criminal penalties include up to five years of imprisonment and a fine of up to $25,000 under 42 U.S.C. §1320a-7b(b).

The Civil Monetary Penalties Law permits physicians who accept or pay kickbacks to be fined in an amount equal to three times the amount of the payment plus up to $50,000 per incident. Those who violate the Anti-Kickback Statute may also be excluded from participating in federal health care programs in the future. Given the potential penalties of Anti-Kickback Statute violations in Michigan, defendants may benefit greatly from speaking with a hard-working attorney to build their defense case.

In many situations where violations of the Anti-Kickback Statute are alleged, it may be possible to demonstrate that a transaction falls under the safe harbor provisions and should be excluded from enforcement. To prove an exception applies, it is usually necessary to have the right evidence that shows compliance with all terms of the exception.

If you are under investigation for a potential kickback, bribe, rebate or other prohibited transaction, it is wise to address the situation as quickly as possible. A knowledgeable Michigan Anti-Kickback Statute violations lawyer can help collect and preserve evidence to fight the allegations and work to protect your rights as you work toward a positive resolution. Call today to learn how you could get started.