{"id":1015,"date":"2015-05-08T11:35:36","date_gmt":"2015-05-08T16:35:36","guid":{"rendered":"https:\/\/federal-lawyer.com\/?page_id=1015"},"modified":"2025-02-21T00:50:27","modified_gmt":"2025-02-21T06:50:27","slug":"defending-anti-kickback-charges","status":"publish","type":"page","link":"https:\/\/federal-lawyer.com\/healthcare-defense\/defending-anti-kickback-charges\/","title":{"rendered":"Anti-Kickback Attorney"},"content":{"rendered":"\n

Anti-Kickback Statute Explained by Experienced Anti-Kickback Lawyers<\/strong><\/h2>\n\n\n\n
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\n\t\"Lynette<\/a>\n\t\t\t
\n\t\t
Attorney Lynette Byrd<\/strong><\/a>
Anti-Kickback Team Lead
Former DOJ Attorney\n\t\t<\/div>\n\t\t\t<\/figcaption>\n<\/figure>\n<\/div>\n\n\n\n
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\n\t\"Nick<\/a>\n\t\t
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Attorney Nick Oberheiden<\/strong><\/a>
Anti-Kickback Team Lead\n\t\t<\/div>\n\t\t\t<\/figcaption>\n<\/figure>\n<\/div>\n\n\n\n
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\"Wade<\/a>
Wade McFaul<\/strong><\/a>
Anti-Kickback Consultant
Former HHS-OIG Assistant Special Agent-in-Charge<\/figcaption><\/figure>\n<\/div><\/div>\n<\/div>\n\n\n\n

The Federal Anti-Kickback Statute makes it a felony to knowingly and willfully offer, pay, solicit, or receive payment, directly or indirectly, in order to gain business reimbursable by any federal health care program, cf. 42 U.S.C. \u00a7 1320a-7b(b).<\/p>\n\n\n\n

Violations of the Anti-Kickback Statute are one of the most common claims in investigations, physician disciplinary proceedings, and board actions. Violations require two elements: compensation between parties and illegal intent involving a federally funded healthcare program.<\/p>\n\n\n\n

What the Government Has To Prove<\/strong><\/h2>\n\n\n\n

The government must prove that the payment between parties occurred and that there was bad intent for the exchange. Intent to violate the law regarding a federal healthcare program is not required.<\/p>\n\n\n\n

(1) Remuneration Explained<\/strong>
\nRemuneration (payment) is exchanging anything of value. The Anti-Kickback law goes into effect once remuneration like gifts, rebates, durable medical equipment, cash, donations, or consulting fees are on offer between parties. Broad in scope, the statute may be violated if only one purpose of a payment is to induce referrals. U.S. v. Greber, 760 F.2d 68 (3rd Cir. 1985).<\/p>\n\n\n\n

Any form of payment or financial benefit to a physician is \u201cremuneration\u201d and can lead to enforcement of the Anti-Kickback Statute. Therefore, it is critical to disprove the existence of bad intent behind payments.<\/p>\n\n\n\n

(2) Intent Requirement<\/strong>
\nAn illegal intent to ask for or give referrals, or to purchase, lease, order, arrange, or recommend any good, facility, or service must occur with remuneration in order to violate the statute when a federal healthcare program could pay for them.<\/p>\n\n\n\n

Under the Patient Protection and Affordable Care Act (PPACA), the government is not required to show that a defendant knew the behavior was illegal. (United States v. Mathur, 2012 WL 4742833 (D. Nev. 2012)). Therefore, a person does not need real knowledge of the Anti-Kickback Statute, nor have specific intent, in order to commit a violation of the law. (42 U.S.C. 1320a-7b(h)). The statute lowers the standard making it easier for the government to prove illegal intent. A judge or jury will determine if intent is clear. (U.S. v. Bradford Regional Medical Center, Civil No. 04-186 Erie, 2013 U.S. Dist. LEXIS 141835 (W.D. Penn. Sept. 30, 2013)).<\/p>\n\n\n\n

It is imperative that individuals show clear and good intent. Any form of knowledge and awareness of wrongdoing can be held against them.<\/p>\n\n\n\n

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