In 1972, Congress passed the anti-kickback statute which made it illegal for providers, including doctors, to knowingly and willfully accept bribes or other forms of remuneration in return for generating Medicare, Medicaid or other federal healthcare program business. Likewise, a physician cannot offer anything of value to induce federal healthcare program business. Since its creation, the anti-kickback statute has been revised to allow more than 20 exceptions or “safe harbors” such as for investments in group practices. Still, there is room for trouble and the statute imposes stiff penalties for violations which are considered felonies.
Safe Harbors include:
Investments in large publicly held health care companies;
Investments in small health care joint ventures;
Space rental;
Equipment rental;
Personal services and management contracts;
Sales of retiring physicians' practices to other physicians;
Referral services;
Warranties;
Discounts;
Employee compensation;
Group purchasing organizations;
Waivers of Medicare Part A inpatient cost-sharing amount;
Increased coverage;
Reduced cost-sharing amounts or reduced premium amounts offered by health plans to beneficiaries;
Price reductions offered to health plans by providers;
Investments in ambulatory surgical centers (ASCs);
Joint ventures in underserved areas;
Practitioner recruitment in underserved areas;
Sales of physician practices to hospitals in underserved areas;
Subsidies for obstetrical malpractice insurance in underserved areas;
Investments in group practices;
Specialty referral arrangements between providers;
and Cooperative hospital services organizations
What is the Anti-kickback rule?
