The consequences of violating the Anti-Kickback Statute and Stark Law in New York aren’t limited to the steep fees and fines. Doctors and health care groups who find themselves in violation of these regulations are often left with a tarnished reputation, exclusion from federal health care programs, and sometimes even prison time.
These fraud and abuse laws are in place to monitor health care compliance, ensuring that patients are receiving safe and quality care. And it’s not only the biggest health systems targeted by these rules. Abuse and fraud are kept in check in every area of healthcare including labs, pharmacies, manufacturers, and managed care providers.
Compounding the issue, noncompliance fines are now uninsurable in some cases, which means that it’s oftentimes the health care executives who are held accountable. These higher-ups are considered personally liable if it has been found that there were major gaps in health care practice oversight.
It’s becoming increasingly common for owners and executives at the senior level to take a portion of the legal blame for health care fraud. And when responsibility falls onto these individuals, at least some of the settlement total is coming out of their pockets.
Avoiding Federal Anti-Kickback Statute violations
It is a federal crime for a physician to pay or be paid for a patient referral. More broadly, nothing of value may be offered to someone who is in a position to provide a patient referral. This can mean anything from inexpensive office space to a free employee.
Stark Law and the Anti-Kickback Statute are enforced by a range of governmental agencies. This includes the Centers for Medicare and Medicaid Services, the Department of Health and Human Services, and the Department of Justice. These laws are in place because the care that patients receive has been shown to suffer when doctors and health care organizations are focused on their own monetary gain rather than what’s best for their patients.