When you work as a medical provider in California, it is important that you prioritize patient health and safety above all else, and that your patient’s needs drive decision-making, rather than the possibility of monetary gain. The Anti-Kickback Statute is a law that seeks to ensure this happens.
Per the U.S. Department of Health and Human Services Office of the Inspector General, the AKS is one of five laws that apply to physicians that seek to prevent health care fraud and abuse.
What the AKS outlines
In simple terms, the AKS makes it illegal to induce or reward patient referrals for services paid by federal health care programs, such as Medicaid or Medicare. It is not always as cut and dry as a doctor accepting money for making referrals. Sometimes, the “reward” for the referral may come in other forms. While it is illegal for health care professionals to offer or make kickbacks, it is also unlawful for them to receive them.
What happens if you violate the AKS
You may face a number of serious penalties for violating the AKS. You may not be able to participate in federal health care programs moving forward, for starters. You may also have to pay fines and potentially spend time behind bars, among other possible penalties. You may also have to pay up to $50,000 per kickback in addition to three times the amount of the kickback paid or received under the terms of the Civil Monetary Penalties Law.
The strength of the AKS case against you depends largely on two things: whether remuneration between you and another party took place and whether there was ill intent involved.