Paying for Referrals is a Bad Idea

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Deadline: May 10, 2017 | Date: May 10, 2017

Venue/Country: Online

Updated: 2017-03-10 14:52:19 (GMT+9)

Call For Papers - CFP

We 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 examine 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 OIG’s Joint Venture Advisory Opinion, 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 also discuss the recent advisory opinion by the OIG regarding Physician-Owned Entities. 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.

Why Should You 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 bring home the realization that the Anti-Kickback Statute is alive, still with us and as viable as ever, and it makes activities that are common 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. In this webinar, you will learn about the elements of the Anti-Kickback Statute, along with the various exceptions and safe harbors that you can rely on for protection against enforcement under these laws. This is important because under recently enacted health care laws, enforcement and health care fraud task forces have been greatly enhanced. In addition, the Affordable Care Act (better known as 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 30 months in prison and ordered her to pay $370,657 in restitution. If that is not enough to 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.

Attend this webinar and learn how to protect yourself and your organization.

Areas Covered in this Webinar

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.

Learning Objectives

To provide the attendee with an understanding of the federal Anti-Kickback Statute and its broad reach.

Give the attendees the tools necessary to protect themselves and their organizations from federal and state enforcement efforts under the Statute.

To discuss the implications of the Statute to healthcare marketing.

Who Will Benefit

- Hospital executives, particularly CEOs, COOs, CFOs, CNOs, and CMOs;

- Nursing home executives;

- Physicians;

- Physician practice managers; and

- Other healthcare provider executives.

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https://www.demystifiedsolutions.com/trainingDetails/Paying-for-Referrals-is-a-Bad-Idea-DEMY051422