The anti-kickback statute makes it a criminal offense to knowingly and willfully offer, pay for, solicit, or receive any remuneration to induce or reward referrals of items or services reimbursable by a federal healthcare program.
by Mario Fucinari, D.C. in Board & Regulatory on Thursday, March 29, 2018
“Remuneration” includes any arrangements where compensation is provided to promote the referral of services or to induce further referrals. For enforcement purposes, the OIG deems that remuneration cannot exceed $10 per item or $50 in aggregate annually.
Both parties involved in a kickback arrangement are criminally liable, and violation of the statute constitutes a felony punishable by a maximum fine of $25,000, imprisonment up to five years or both.
Conviction will also lead to automatic exclusion from federal healthcare programs— including Medicare and Medicaid. In addition, the OIG may initiate administrative proceedings to impose civil monetary penalties.
- Civil monetary penalty provision prohibiting inducements to beneficiaries are described in section 1128A(a)(5) and 1128A(a)(7) of the Social Security Act
- Exclusion authority details appear in section 1128(b)(7)
- Commission of acts are described in section 1128B(b)