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new york Stark antikickback lawyers

August 30, 2020

 

New York Stark and anti-kickback lawyers

42 United States Code section 1395nn contains what is commonly called the physician self-referral law, otherwise known as the Stark law. It prohibits doctors from directly or indirectly referring patients for a broad range of designated health care services that are to be paid by Medicare or Medicaid when the entity that the patient is referred to has an immediate financial relationship with the referring doctor or an immediate family member. It also prohibits the entity to which the patient was referred from billing Medicare or Medicaid for those services.

Strict liability
Proof of intent to violate the physician self-referral law is not required. It is a strict liability offense, punishable by fines of up to $15,000 for each service that a person knew or should have known was contrary to statute. Violators also face exclusion from participation in federal health care programs. Additional fines of up to $100,000 can be assessed for attempting to circumvent the law and each attempt to do so. There are exceptions to the statute, but they are detailed and highly specific.

Critics of self-referral argue that it creates a conflict of interest because the doctor derives a benefit from his or her own referral which can result in overutilization of services and limit competition by other providers of the same health care services at lower rates.

Anti-Kickback statute
The federal anti-kickback statute is found at 42 United States Code section 1320a-7b. It forbids the offer of an exchange or the actual exchange of anything in value for referring federal health care business. Pursuant to applicable case law, if one purpose of a payment, offer of exchange or exchange of anything of value is for purposes of inducing future referrals, the anti-kickback statute has been violated. A first conviction of the anti-kickback statute can result in five years in prison and a fine not to exceed $25,000 along with being mandatorily excluded from federal health care programs. Even without a conviction, one might face discretionary exclusions from the programs. Civil treble damages plus $50,000 for each violation of the statute can also be assessed. Under the Affordable Care Act, actual knowledge of a violation of the anti-kickback statute or the specific intent to violate it is not necessary to support a conviction. Prosecutors need only prove that a person intended to violate the law, but not the anti-kickback statute itself.

Our health care attorneys are knowledgeable and experienced in both Stark and anti-kickback law. If you own a medical practice or health care business, talk with us and we’ll help you navigate through these two complex statutes. If there’s an exception available to you, we’ll find it, and we’ll advise you accordingly, and then we’ll help keep you in compliance too. The Centers for Medicare and Medicaid Services (CMS) has defined and published certain “safe harbor” regulations that discuss conduct and business relationships that are not contemplated by the anti-kickback statute. Assuming that all conditions are met, nobody gets prosecuted for the business relationship.

Our health care practice attorneys assist hospitals, clinics, physicians and other health care providers with proposed transactions in efforts to eliminate the risk of lawsuits or prosecutions. All contracts with service providers who might be a source of referrals must be analyzed accordingly. Due care and caution should be exercised in working within these statutes as enforcement by government agencies at all levels has shifted gears, and penalties are severe. Even innocent technical oversight involving either one of the laws can be determined to be violations.

Don’t hesitate to arrange for an appointment with us to discuss your Stark or anti-kickback law questions. We’re primarily litigators, but we would far rather help keep you in compliance than defend you in federal court. We have three offices in New York City, so just call 888-533-5686 to arrange for that consultation.

Christine Twomey
Christine Twomey
2024-03-21
Just had my Divorce case settled 2 months ago after having a horrible experience with another firm. I couldn’t be happier with Claire Banks and Elizabeth Garvey with their outstanding professionalism in doing so with Spodek Law Group. Any time I needed questions answered they were always prompt in doing so with all my uncertainties after 30 yrs of marriage.I feel from the bottom of my heart you will NOT be disappointed with either one. Thanks a million.
Brendan huisman
Brendan huisman
2024-03-18
Alex Zhik contacted me almost immediately when I reached out to Spodek for a consultation and was able to effectively communicate the path forward/consequences of my legal issue. I immediately agreed to hire Alex for his services and did not regret my choice. He was able to cover my case in court (with 1 day notice) and not only was he able to push my case down, he carefully negotiated a dismissal of the charge altogether. I highly recommend Spodek, and more specifically, Alex Zhik for all of your legal issues. Thanks guys!
Guerline Menard
Guerline Menard
2024-03-18
Thanks again Spodek law firm, particularly Esq Claire Banks who stood right there with us up to the finish line. Attached photos taken right outside of the court building and the smile on our faces represented victory, a breath of fresh air and satisfaction. We are very happy that this is over and we can move on with our lives. Thanks Spodek law 🙏🏼🙏🏼🙏🏼🙏🏼🙌🏼❤️
Keisha Parris
Keisha Parris
2024-03-15
Believe every single review here about Alex Z!! From our initial consultation, it was evident that Alex possessed a profound understanding of criminal law and a fierce dedication to his clients rights. Throughout the entirety of my case, Alex exhibited unparalleled professionalism and unwavering commitment. What sets Alex apart is not only his legal expertise but also his genuine compassion for his clients. He took the time to thoroughly explain my case, alleviating any concerns I had along the way. His exact words were “I’m not worried about it”. His unwavering support and guidance were invaluable throughout the entire process. I am immensely grateful for Alex's exceptional legal representation and wholeheartedly recommend his services to anyone in need of a skilled criminal defense attorney. Alex Z is not just a lawyer; he is a beacon of hope for those navigating the complexities of the legal system. If you find yourself in need of a dedicated and competent legal advocate, look no further than Alex Z.
Taïko Beauty
Taïko Beauty
2024-03-15
I don’t know where to start, I can write a novel about this firm, but one thing I will say is that having my best interest was their main priority since the beginning of my case which was back in Winter 2019. Miss Claire Banks, one of the best Attorneys in the firm represented me very well and was very professional, respectful, and truthful. Not once did she leave me in the dark, in fact she presented all options and routes that could possibly be considered for my case and she reinsured me that no matter what I decided to do, her and the team will have my back and that’s exactly what happened. Not only will I be liberated from this case, also, I will enjoy my freedom and continue to be a mother to my first born son and will have no restrictions with accomplishing my goals in life. Now that’s what I call victory!! I thank the Lord, My mother, Claire, and the Spodek team for standing by me and fighting with me. Words can’t describe how grateful I am to have the opportunity to work with this team. I’m very satisfied, very pleased with their performance, their hard work, and their diligence. Thank you team!
Anthony Williams
Anthony Williams
2024-03-12
Hey, how you guys doing? Good afternoon my name is Anthony Williams I just want to give a great shout out to the team of. Spodek law group. It is such a honor to use them and to use their assistance through this whole case from start to finish. They did everything that they said they was gonna do and if it ever comes down to it, if I ever have to use them again, hands-down they will be the first law office at the top of my list, thank you guys so much. It was a pleasure having you guys by my side so if you guys ever need them, do not hesitate to pick up the phone and give them a call.
Loveth Okpedo
Loveth Okpedo
2024-03-12
Very professional, very transparent, over all a great experience
Bee L
Bee L
2024-02-28
Amazing experience with Spodek! Very professional lawyers who take your case seriously. They treated me with respect, were always available, and answered any and all questions. They were able to help me very successfully and removed a huge stress. Highly recommend.
divesh patel
divesh patel
2024-02-24
I can't recommend Alex Zhik and Spodek Law Firm highly enough for their exceptional legal representation and personal mentorship. From the moment I engaged their services in October 2022, Alex took the time to understand my case thoroughly and provided guidance every step of the way. Alex's dedication to my case went above and beyond my expectations. His expertise, attention to detail, and commitment to achieving the best possible outcome were evident throughout the entire process. He took the time to mentor me, ensuring I understood the legal complexities involved to make informed decisions. Alex is the kind of guy you would want to have a beer with and has made a meaningful impact on me. I also want to acknowledge Todd Spodek, the leader of the firm, who played a crucial role in my case. His leadership and support bolstered the efforts of Alex, and his involvement highlighted the firm's commitment to excellence. Thanks to Alex Zhik and Todd Spodek, I achieved the outcome I desired, and I am incredibly grateful for their professionalism, expertise, and genuine care. If you're in need of legal representation, look no further than this outstanding team.

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