Application of the Medicare and Medicaid anti-kickback statute to business arrangements between hospitals and hospital-based physicians.

Medicare and State health care programs: fraud and abuse; OIG anti-kickback provisions--HHS. Final rule.

This final rule implements section 14 of Public Law 100-93, the Medicare and Medicaid Patient and Program Protection Act of 1987, by specifying various payment practices which, although potentially capable of inducing referrals of business under Medicare or a State health care program, will be protected from criminal prosecution or civil sanctions under the anti-kickback provisions of the statute.

Beyond the anti-kickback statute: new entities, new theories in healthcare fraud prosecutions.

The authors analyze existing and developing trends in healthcare fraud litigation. They first review the traditional use of the Medicare-Medicaid Anti-Kickback Statute to prosecute such fraudulent activity. They then consider newer theories that have been employed, or may be employed, in cases involving payors, middlemen, agents, and fiduciaries. These include the use of the Civil False Claims ...

Defining "willful" remuneration: how Bryan v. United States affects the scienter requirement of the Medicare/Medicaid anti-kickback statute.

Physician refer thyself: is Stark II, phase III the final voyage?

The United States spends more of its wealth on healthcare than any other developed country, and that share is rising. Supporters of the free market system point to the regulatory burden on the healthcare industry. Estimates of the regulatory costs of US healthcare range from dollars 58 billion to dollars 339 billion. A recent report indicates that approximately dollars 8 billion of the US healt...

The Stark truth about the Stark law. Part I.

challenges to physicians – those with specific business interests as well as those whose sole focus is patient care. Understanding the law and knowing which, if any, of the many Stark exceptions apply to your arrangement is essential. Part I of this series explained the purpose of the Stark statute, how it differs from the anti-kickback statute and how you can determine whether it applies to ...