People in just about any kind of business who have the responsibility for deciding who is awarded a contract or gets a lucrative business deal can find themselves being offered a kickback. Basically, a kickback is a bribe. How does this apply to doctors?
It’s illegal under the federal Anti-Kickback Statute (AKS) to knowingly offer or accept anything of value (“remuneration”) that is reimbursable through federally funded health care programs such as Medicaid and Medicare. Note that remuneration isn’t necessarily cash. Often, cash never changes hands directly. However, a company may name a doctor as a consultant – a job that can come with a lot of money and virtually no work.
Understanding the AKS
The AKS is most often used against physicians when they accept incentives from representatives of prescription drug companies and companies that make durable medical equipment (DME) and other medical devices.
Physicians can also violate the AKS by offering or accepting incentives from other medical professionals to recommend them to their patients whose medical care is covered by a federal health program. It didn’t matter whether the patient was helped or harmed.
Remuneration doesn’t have to involve cash. It can be a vacation or the use of a private jet or yacht. It may involve creating a “consultant” position for someone that comes with considerable compensation for little or no work.
The potential consequences
Those convicted of violating the AKS can potentially face prison time. Even if they don’t, they can be fined substantial amounts and be prohibited from treating patients who receive Medicare or Medicaid.
If you have questions about whether something is a violation of the AKS, seek legal guidance before you do it. If you’re already under investigation or facing charges, make sure that your rights are protected.