Which of the following is prohibited by the Anti-Kickback Statute?
The federal Anti-Kickback Statute is a healthcare fraud and abuse statute that prohibits the exchange of remuneration—which the statute defines broadly as anything of value—for referrals for services that are payable by a federal program, which, in the context of healthcare providers, is Medicare.
What is the difference between anti-kickback and Stark law?
Source of Prohibited Referrals: Whereas the Stark Law only pertains to referrals from physicians, the Anti-Kickback Statute applies to referrals from anyone. A violation of the Anti-Kickback Statute constitutes a federal felony punishable by up to 5 years in prison and up to a $25,000 fine for each violation.
What are the goals of the Anti-Kickback Statute?
At its heart, it is an anti-corruption statute designed to protect federal health care program beneficiaries from the influence of money on referral decisions and thus is intended to guard against overutilization, increased costs, and poor quality services.
What is the intent of safe harbor legislation?
The safe harbor protects certain arrangements when an individual or entity agrees to refer a patient to another individual or entity for specialty services in return for the party receiving the referral to refer the patient back at a certain time or under certain circumstances.
How do you invoke safe harbor?
Invoking Safe Harbor A nurse is free to invoke safe harbor at any time during their shift, including if an assignment changes along the way. To invoke safe harbor, the nurse must notify the supervisor in writing that they are invoking safe harbor.
What is a safe harbor under the Stark Act?
The safe harbor regulations define payment and business practices that will not be considered kickbacks, bribes, or rebates that unlawfully induce payment by Medicare or Medicaid programs. The regulations specify allowable financial and referral relationships between physicians or other providers and suppliers.
What is a safe harbor investment?
A Safe Harbor 401(k) plan is a type of 401(k) with an employer match that allows you to avoid most annual compliance tests. If a 401(k) includes a Safe Harbor provision, the employer makes annual contributions on behalf of employees, and those contributions are vested immediately.
What is the safe harbor rule for 2019?
The safe harbor provides that an individual domiciled in California who is outside California under an employment-related contract for an uninterrupted period of at least 546 consecutive days will be considered a nonresident unless any of the following is met: • The individual has intangible income exceeding $200,000 …
What is the discount safe harbor?
With regard to the point of sale discount, the new safe harbor protects reductions in price on prescription pharmaceutical products offered to plan sponsors under Medicare Part D, Medicaid MCOs, or through a PBM acting under contract with either if: (1) the reduction in price is set in advance; (2) the reduction in …
What is the personal services safe harbor?
The Safe Harbor requires the parties to regularly monitor and assess performance under the arrangement, including the impact of the outcomes-based payment arrangement on patient quality of care.
What are exceptions to the Stark law?
Non-Monetary Exception – This exception to the Stark Law applies to the payment of non-monetary compensation to a physician of up to $300 per year, if the physician did not solicit the compensation and it does not take into the account the volume or value of referrals.
Which of the below prohibits willfully offering paying soliciting or receiving any remuneration to induce the purchase or order of a drug that may be paid for by a federal health care program?
Section 1128B(b) of the Social Security Act, previously codified at sections 1877 and 1909, provides criminal penalties for individuals or entities that knowingly and willfully offer, pay, solicit or receive remuneration in order to induce business reimbursed under the Medicare or State health care programs.
What is the OIG one purpose rule?
The AKS prohibits paying or receiving anything of value, regardless of form (gifts, certain discounts, cross-referrals between parties), for the purpose of inducing or rewarding another party for referrals of services paid for by Medicare, Medicaid, and other programs.
What are illegal beneficiary inducements?
The federal Beneficiary Inducement Statute (“BIS”) prohibits an individual or entity from providing remuneration to patients who are eligible for Medicare or Medicaid benefits if that individual or entity knows (or should know) that doing so is likely to influence the patient’s decision to order or receive items or …
What is the Medicare and Medicaid Patient and Program Protection Act of 1987?
The Medicare and Medicaid Patient and Program Protection Act of 1987 (P.L. 100-93) strengthened authorities to sanction and exclude providers from the program and established criminal penalties for fraud against Medicare, Medicaid, and other federal health care programs.
What is remuneration in Anti Kickback Statute?
§ 1320a-7, noted that the inclusion of “remuneration” in the statute “demonstrate[s] congressional intent to create a very broadly worded prohibition,” and explained that “remuneration” under the AKS means “anything of value in any form or manner whatsoever.” See OIG Anti-Kickback Provisions, 56 Fed.