The Federal Anti-Kickback Law

Paper Summary:

This paper describes the Federal Anti-Kickback Law, (42 U.S.C.S. 1320a-7b(b)), which prohibits a person from paying or seeking payment in exchange for referred business that will be reimbursed by a federal health care program, including Medicaid. These violations are a felony and can have severe consequences. However, the law does have several safe harbors. Nonetheless, because the law has been narrowly interpreted in the courts, the writer believes that the proposed arrangement in this joint venture agreement with another medical group appears to possibly violate the Federal Anti-Kickback Law.

From the Paper:

"The Office of Inspector General (OIG) of the U.S. Department of Health is in charge of enforcing the Federal Anti-Kickback Law. The OIG has developed regulations to help ensure compliance with the Law, but is also aware that many contemplated arrangements may not fall within the safe harbors, but still would not violate the Law. Therefore, the OIG will provide advisory opinions about specific proposed business arrangements."

Sample of Sources Used:

• 42 C.F.R. 1001.952.
• 42 U.S.C.S. 1320a-7.
• Ambulance & Hosp. Rental Serv. Inc., 874 F.2d 20 (1st Cir. 1989).
• Feldstein v. Nash Community Health Servs., Inc., 51 F. Supp. 2d 673 (E.D.N.C. 1999)
• Hanlester Network v. Shalala, 51 F.3d 1390 (9th Cir. 1995) and United States v. Bay State

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