The federal government has various tools for combatting health care fraud and abuse, and that includes the Anti-Kickback Statute. As one of the most well-known federal fraud statutes, the AKS has far-reaching implications for many business relationships in the health care, pharmaceutical, and medical device industry. Because it also poses severe criminal, civil, and administrative penalties, anyone subject to the AKS should prioritize regulatory compliance and immediate defense against enforcement actions.
Hendershot, Cannon & Hisey, P.C. is nationally recognized for our work in health care and medical law, including matters of regulatory compliance and health care fraud defense. In an era marked by increasingly harsh regulations, scrutiny, and penalties, our team delivers the counsel and representation to help practitioners, providers, and others in the health care space minimize their exposure to serious consequences and navigate high stakes matters.
Our firm has over 26 years of experience in health and medical law. Speak with a lawyer about your particular needs by calling (713) 909-7323 or contacting us online.
The Anti-Kickback Statute (42 USC § 1320a-7b(b)), is a federal criminal statute that prohibits transactions intended to reward or induce referrals / business for any service or item reimbursed by a federal health care program. The AKS, at its core, is an anti-corruption statute, and it is designed to prevent fraud and protect the federal government. It is also incredibly broad in scope, and can subject alleged offenders in a range of sectors to both criminal and civil penalties.
Due to the expansiveness of the Anti-Kickback Statute, there are a few core concepts worth knowing. These include:
Violations of the Anti-Kickback Statute can subject providers, individuals, and other health care business professionals to severe criminal and civil penalties.
Civil / Administrative Penalties
The serious penalties imposed by the Anti-Kickback Statute make it critical for any health care practitioner and business involved in federally payable transactions to carefully construct their relationships and medical contracts in order to ensure compliance. Our team takes a proactive and comprehensive approach to assessing risk exposure in any existing and new arrangement, billing agreement, medical practice set-up and acquisition, and high-risk areas or services, such as clinical visits, compounding pharmacies, and ancillary lab service and pharmaceutical referrals.
The use of safe harbors can also protect certain business and payment practices which would otherwise be prohibited under the AKS. Protection under a safe harbor requires arrangements to meet all qualifying criteria, a task that is complex and highly risky when done incorrectly. Our team at Hendershot, Cannon & Hisey, P.C. has extensive experience helping clients evaluate fair market value, construct and maintain sound compliance plans, and understand and meet safe harbor requirements, which can address arrangements such as:
Prevention is the best medicine when it comes to avoiding AKS violations and FCA liability, and reducing exposure to increased scrutiny, costly audits and investigations, and potentially devastating penalties.
Our attorneys are well-versed in providing the immediate defense clients require during all aspects of audits, investigations, and various enforcement actions. This includes our immediate assistance helping clients prepare for, respond to, and navigate matters involving:
If you have questions regarding the Anti-Kickback Statute, compliance in any health care transaction, or potential violations and investigations, the time to act is now. Health care fraud compliance and defense matters demand immediate and decisive action, as well as the attention of proven attorneys. Our legal team is available to personally and confidentially discuss your case, and discuss potential strategies tailored specifically to your needs. Our health care compliance and defense team at Hendershot, Cannon & Hisey, P.C. serves clients throughout Texas and the U.S.
Call (713) 909-7323 or contact us online to speak with a member of our team.