The webinar will provide an overview of the Anti-Kickback Statute (AKS), a review what it prohibits, and the Statute’s available safe harbors. It will also show how violation of the AKS can raise FCA concerns, and it will provide an assessment of enforcement activities, showing how health care providers and organizations may be at risk. Additionally, the webinar will review recent cases and show how they potentially impact participants. The webinar will provide an in-depth review of the AKS, focusing on what is prohibited under the Act and what the exceptions are. We will also review the case law, particularly the early case law that sets the stage and basis for how the courts interpret the law.
Since one of the exceptions to enforcement under the Act is regulations promulgated by the Secretary, the “safe harbors,” payment practices that will not be subject to criminal
prosecution and that will not provide a basis for civil monetary penalties or exclusion from the Medicare or Medicaid programs, we will review these safe harbors, particularly those more frequently used, to show how protection from enforcement can be achieved.
Specifically, we will review the investment, space and equipment rental, personal services/management contracts, and physician recruitment safe harbors.
In addition, we will discuss the Joint Venture Advisory Opinion from the Office of the Inspector General (OIG), where a hospital expands into a related service line by contracting with an existing provider of that service. The OIG has significant problems with such an arrangement. We will as well discuss the recent advisory opinion by the OIG regarding Physician-Owned Entities (PODs). OIG views PODs as inherently suspect under the AKS because the opportunity for a referring physician to earn a profit, including through an investment in an entity for which he or she generates business, could constitute illegal remuneration under the AKS.
Finally, the webinar will review various cases to show how easy it is to run afoul of the Statute, and how the courts view compliance with it.
Objectives of the Presentation:
To provide an understanding of the scope of the Anti-Kickback Statute and to prepare participants to protect themselves and their organizations from enforcement activities under the Statute.
Areas Covered:
- Federal Civil Anti-Kickback Statute,
- Safe Harbors providing protection under the AKS,
- Enforcement activities involving the AKS,
- The OIG’s Joint Venture Advisory Opinion,
- The OIG’s advisory opinion regarding Physician-Owned Entities, and
- The anti-fraud provisions of the Affordable Care Act.
Who will benefit:
- Hospital executives, particularly CEOs, COOs, CFOs, CNOs, and CMOs;
- Nursing home executives;
- Physicians;
- Physician practice managers; and
- Other healthcare provider executives.
Why you should attend:
This session is designed for health care executives, physicians and other health care providers who participate in and receive remuneration from Medicare, Medicaid, and other federal health care programs such as TriCare. Several recent cases demonstrate that the Anti-Kickback Statute is as viable as ever, and it makes activities that are commonly accepted in other industries a crime.
As a health care executive, physician or other health care provider, you should be very concerned about the potential for the government to use the Anti-Kickback Statute as one of the prime methods for enforcing the federal fraud and abuse laws. It is also concerning that, along with Stark II (the federal physician anti-referral law), the Anti-Kickback Statute can be and is being used as the basis for an action brought under the Federal False Claims Act (FCA). In this webinar, you will learn about the Anti-Kickback Statute, as well as the various exceptions and safe harbors that you can rely on for protection against enforcement. This is important because under recently enacted health care laws, enforcement and health care fraud task forces have been greatly enhanced. In addition, under the Affordable Care Act (a/k/a “Obamacare”), the government has greatly enhanced enforcement resources.
Two cases, The Christ Hospital case in Cincinnati, with a settlement in excess of $100 million and the Hardeman Memorial Hospital case in Texas, with a settlement of $398,230.56 stand out. In addition, in the Hardeman case, the Texas federal court sentenced former CEO Angela Edwards to 2 ½ years in prison and ordered her to pay $370,657 in restitution. If that does not get your attention, consider the recent cases finding that the “responsible corporate officer doctrine” allows the government to hold hospital CEOs and others directly responsible for the fraud
Instructor Profile
William Mack Copeland, MS, JD, PhD, LFACHE, practices health care law in Cincinnati at the firm of Copeland Law, LLC, where he is president and CEO. He is also president of Executive & Managerial Development Group, a consulting entity providing compliance and other fraud and abuse related services, and Senior Vice President, Business Development, at ExecuConnections*, a healthcare executive placement firm. A graduate of Northern Kentucky University Salmon P. Chase College of Law, Bill is a frequent author and speaker on health law topics. Copeland is a member of the American Health Lawyers Association, American, Ohio and Cincinnati Bar Associations and is a life fellow in the American College of Healthcare Executives. He was awarded the American College of Health Care Executives Senior-Level Healthcare Executive Regent’s Award in 2007
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