When navigating the complex landscape of healthcare regulations, it’s essential for medical professionals to understand the distinctions and nuances of laws that govern their practices. Two critical pieces of legislation that often come into play are the Anti-Kickback Statute and the Stark Law. Both aim to prevent fraud and abuse within the healthcare system, but they operate under different principles and requirements.
Understanding these laws is vital for healthcare providers, as violations can lead to severe penalties, including fines and exclusion from federal healthcare programs. Hence, having a knowledgeable attorney who can help interpret and apply these laws is indispensable.
The Anti-Kickback statute is codified under 42 U.S.C. § 1320a-7b.
These are federal statutes that apply nationally in every State. In short, these statutes stand for the proposition that it is a crime for a dentist, a physician, or a chiropractor to knowingly or willfully offer, pay, solicit, or receive remuneration, directly or indirectly, in cash or in kind, in exchange for, referring an individual, or furnishing or arranging for a good or service, and for which payment may be made under Medicare or Medicaid. The Anti-Kickback Statute is similar to Stark law, however, one of the main distinctions is that while Stark law does not have an intent (to commit the act) requirement, the Anti-Kickback statute do. This means to be found guilty of violating the Anti-Kickback statute, the government must prove that you had the requisite intent to break the law. On the other hand, the Stark law can be violated even if you do not intend to break the law. Our Maryland healthcare attorney understands the differences between Stark Law and Anti-Kickback statute and consider them when representing your dental and medical practices.
The Anti-Kickback Statute “Safe Harbors”
The Anti-Kickback Statute and regulations contain several “safe harbors” and other parameters for dentists, physicians, and chiropractors for establishing compliant relationships –including the need for “fair market value” compensation. These safe harbors are:
a- Personal services
b- Space and equipment leases
c- Sale of medical practice
d- Practitioner recruitment
e- Employment agreements
f- Others
Failure to meet the requirements of a safe harbor does not make an arrangement illegal for a dentist or a physician but it may be investigated and prosecuted. While many Stark law exceptions bear similarity to the Anti-Kickback safe harbors, most Stark Law exceptions applicable to practice acquisitions and physician employment have fair market value and commercial reasonableness requirements, including the bona-fide employment exception, the personal services arrangement exception, and the fair market value exception.
When buying or operating a dental or medical practice in Maryland, you should be well represented by a Maryland Healthcare attorney to try to avoid the legal issues that arise from these complicated statutes.
Book Your Consultation with our Maryland healthcare attorney and medical contract attorney today!
Kamkari law
Maryland Healthcare Lawyer & Attorney
