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Stark Anti-kickback Lawyers

Healthcare professionals such as hospitals, urgent care centers and physicians who treat recipients of Medicare and Medicaid qualify to be reimbursed for the services they provide. As a way to eliminate incentives to make improper referrals that result in Medicare or Medicaid payments, anti-kickback laws were passed.

These laws are designed to prevent inappropriate payments from these government insurance programs. Enforcement attempts to curtail overutilization of medical services by a narrow group while preserving competition among healthcare providers. State and federal laws exist within anti-kickback legislation to carryout prohibited self-referrals.

Knowingly or willfully offering, paying, receiving or soliciting bribes, rebates or kickbacks in exchange for Medicare or Medicaid paid services can lead to criminal penalties.

Related Laws

The potential of liability for an anti-kickback violation abounds because there are many federal and states laws that address this issue. State self-referral prohibitions, which are similar to federal Stark regulations, are applicable to all types of payors and creates the potential of liability for health care providers.

These entities must also be aware of the corporate practice that governs medicine prohibitions. Many states have these and apply specific Medicare rules to different providers. Some examples that can cause problems for providers include set conditions for various entities for participating in the programs, licensure or certification standards and the Anti-Markup Rule.

Activities That Violate Anti-Kickback Law

Proof that a healthcare provider intentionally violated anti-kickback statutes to receive some type of compensation from Medicare or Medicaid is required. Examples of which activities raise suspicions of anti-kickback violations include:

• Receiving below the fair market rate for medical facilities in exchange for Medicare or Medicaid referrals
• When cash bonuses are given to a hospital from a diagnostic testing center or lab for Medicare and/or Medicaid patient referrals
• Referring physicians receive below market value patient care coordinating services to physicians
Nursing homes receive pharmacy services from a pharmaceutical company after they offer monetary incentives to ensure the nursing homes use the company’s drug supplies for Medicare and Medicaid recipients
• Kickbacks are given to medical providers so a pharmaceutical company can increase its sales of a specific drug
• Medicare and Medicaid patients receive promotional offers from a drug store chain when they transfer their prescriptions to that store
• A nursing home receives free discharge planning from a hospice provider in exchange for referrals

Penalties for Violating Anti-Kickback Laws

There are severe criminal penalties for medical providers who violate federal anti-kickback laws. Some could receive a fine of up to $25,000, a five year prison sentence and even be excluded from future participation in either of these government insurance programs.

Civil cases also come with penalties. For each kickback violation, medical providers can be charged a fee as much as $50,000 per kickback. Violating these laws may also lead to a False Claims Act violation.

Permissible Safe Harbor Transactions

While healthcare providers across the industry are subject to high penalty violations, there are certain prohibited anti-kickback transactions that are permissible when meeting the standards of safe harbor regulations. Typically, these referrals involve:

• Academic surgical centers
• Affiliated health centers
• Ambulatory surgical centers
• Certain discounts
• Investment interests
• Items and services that are designated for HER
• Payments to legitimate employees
• Recruiting practitioners
• Warranties

A lawyer who is experienced with anti-kickback regulations on the state and federal level is the best consultant to know whether an action will lead to violating parts of the law. Providers should get clearance before entering into a referral situation or new business transaction.

Get San Diego Stark Anti-Kickback Lawyers on Your Side

At Raiser & Kenniff, PC, our dedicated San Diego Stark anti-kickback lawyers work with medical providers such as healthcare practice groups, hospitals and individual physician practices to make sure they maintain compliance with state and federal anti-kickback laws. We will also defend against any charges of violation that you may face.

Our experienced lawyers will help you draft compliance policies to ensure your medical service remains intact. We are on your side whether you need assistance with building a strong defense against civil or criminal anti-kickback violations or a program that helps you avoid this type of legal entanglement.

These are serious charges that can threaten the viability of your medical practice or hospital. Contact us today without delay.


Charle Butler
Charle Butler
2021-03-12
Verified
I was hesitant to hire the Spodek Law Group. I read reviews and knew they have a great reputation. However, I thought I would spend money and not see or speak to my attorney. From the beginning to end of my case Todd and the entire staff were available and willing to help. We worked towards and end result that was way above my expectation and Todd delivered. I am forever grateful for patience and long days and night spent working on my case. Thanks Todd and the entire team!
Mesonista parsons
Mesonista parsons
2021-03-05
Verified
My attorney at Spodek was Abigail. She was very knowledgeable and helpful with all my questions and concerns, as well as responsive. Her fees are affordable and Abigail took the time to make sure I understood everything relating to my case. I highly recommend Abigail and will request her services in the future.
debabrata chakraborty
debabrata chakraborty
2021-03-03
Verified
Todd A Spodek is the experienced and best criminal lawyer at USA. He is very professional and always respond on time. Alex also very cooperative and always help me. They took care me and my problem like family member. I am 100% satisfied for their professional service. My result was unexpected and amazing. They dismissed my case. I am really grateful to them. I will recommend you to go there if you want to solve your problem. I wish all the best for them.
Asata Hendricks
Asata Hendricks
2021-03-02
Verified
Truly appreciate the work the guys did!. Exceptional team & I know they care about each and everyone of their clients. I am super thankful to be referred to Spodek Law Group and I am grateful Todd & Alex were able to work diligently to achieve an outcome I am pleased with. Despite COVID they stayed on top of things and kept me informed every step of the way. Very thankful.
Mike Moroff
Mike Moroff
2021-02-26
Verified
I'm very satisfied with the services rendered by Todd, Alex and Mary Lou. I whole heartedly recommend Spodek Law Group . I've worked with and have retained other attorneys in the past with Todd's firm being the cream of the crop for many reasons. A very serious legal matter was resolved after a year's hard work and effort. Todd expertly guided me through the process and was able to navigate and make the good journey bearable as well as successful. Mary Lou initially provided excellent assistance before referring my case to Todd. Alex's support was effective and timely. The customer portal (MyCase) is an invaluable communication tool that also kept track of my case. Various aspects of my case were explained and there were several options provided but I made the final decision of how the case would be handled. The legal fee was reasonable considering the effort and amount of work plus it was a flat fee regardless of the length of time required to conclude my case. Todd made himself available to me and we had many scheduled meetings to go over the progress and to discuss the next steps. I felt more confident after many discussions with him. You will not go wrong choosing Spodek Law Group for legal matters.
Josh Katz
Josh Katz
2021-02-24
Verified
Being that it was the first time that I was in need of an attorney, I was afraid and hesitant and knew I needed the absolute best. It is beyond understood why Spodek Law Group has a reputation of being the top, if not the best law firm in New York. Alex and Abigail were there every step of the way even at the most unconvenient hours. I could not have asked for more. They are extremely good at what they do and they delivered much much more than just winning my case. A big thank you to Alex and Abigail for all the guidance and counseling and their upmost loyal support that extended far more than just legally. If you need the absolute best than don't hesitate to hire Spodek Law Firm.
L.C.
L.C.
2021-02-24
Verified
I cannot tell you how thankful I am to Todd and Alex for their hard work and dedication to my case. I had never been in any trouble before but I had an unfortunate event occur and in the midst of COVID-19 at that therefore I knew I needed a team that was dedicated to my success. Today- my case has been finalized and I’m walking away with no record and can continue life as a mother and a Grad student worry free. I cannot express enough gratitude for their assistance.
AnnMarie Soliman
AnnMarie Soliman
2021-02-23
Verified
I received a summons and called Spodek law group for a free consultation. Alex took my call and was very quick and responsive. He was available anytime through multiple platforms and very reassuring when needed. They are extremely organized and thorough. They got my case dismissed! I’m very grateful. Thank you Alex and Todd!

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"Spodek Law Group have offered me excellent support and advice thru a very difficult time. I feel I've dealt with someone who truly cares and wants the best outcome for you and yours. I'm extremely grateful for all the help Spodek Law Group has offered me. I can't recommend them..."

David Bruce

"Spodek Law Group was incredibly professional and has given me the best advice I could wish for. They had been helpful and empathetic to my stressful situation. Would highly recommend Spodek Law Group to anyone I meet."

Rowlin Garcia

"Best service I ever had. Todd is absolutely class personified. You are in the safest hands with spodek. They have their clients interest in mind."

Francis Anim
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