Anti-Kickback and Stark Law Defense Lawyer

Anti-Kickback and Stark Law Defense Attorney

Navigating the nuanced landscape of healthcare regulations requires a strong understanding of the different laws that have been designed to prevent fraud and abuse. This includes the Anti-Kickback Statute and the Stark Law, which are federal regulations to help safeguard medical decisions from being influenced by improper financial incentives. If you’ve been accused of violating these laws, an experienced Anti-Kickback and Stark Law defense lawyer can protect your rights.

At the Law Offices of Barry M. Wax, we understand how overwhelming it can feel to be accused of violating something as significant as the Anti-Kickback Statute and the Stark Law. Our deep understanding of healthcare regulations can provide the insight and legal representation you need to navigate your case as efficiently as possible. From day one, we can work to prioritize your reputation and financial stability by making sure no one takes advantage of your rights throughout each stage of the legal process.

How to Defend Against Anti-Kickback and Stark Law Allegations

Both the Anti-Kickback Statute and the Stark Law are two extremely powerful pieces of legislation that were designed to prevent healthcare fraud. The Anti-Kickback Statute prohibits anyone from experiencing personal financial gain for referring an individual or entity to a federal healthcare program. The Stark Law restricts physician referrals from happening if a pre-existing financial relationship exists.

Some of the most common defense strategies in these cases include:

Understanding Intent and Knowledge Requirements

One key factor in defending against allegations of violating either of these laws is proving intent. It is on the government to demonstrate that there was a willful intent for the plaintiff to offer or receive something of value in exchange for healthcare referrals. To combat this, a defense lawyer can make the case that their client did not have the necessary intent to break the law and, therefore, should not be legally charged for the crime.

Demonstrating Compliance With Safe Harbors and Exceptions

Both the Anti-Kickback Statute and the Stark Law have specific provisions known as safe harbors and exceptions. These allow for specific transactions or relationships that could otherwise signal a conflict of interest. For example, under the Anti-Kickback Statute, some safe harbors cover certain leasing agreements, investments, and compensation agreements. A defense lawyer can assess whether the alleged conduct qualifies for an exception or not.

Arguing the Lack of a Financial Benefit

Another possible defense is to show how the alleged arrangement did not provide any financial benefit to the healthcare provider in question. This must be established through physical evidence that there were no payments or incentives resulting in an increase in referrals or financial gain. If this is true, the case against the defendant can be weakened. Bringing in financial experts as an extra layer of support can be a huge help to make this point.

Proving a Legitimate Business Purpose

While a specific healthcare arrangement might have been brought to court out of suspicion that it was illegal, the defense will have an opportunity to prove its legal validity. This will require the defendant to share how the arrangement served a legitimate business purpose that is completely unrelated to making any new referrals or money. For example, if a hospital were to lease a new office space to a physician, they need to show how the lease terms are of fair market value.

Documenting Compliance Efforts

Demonstrating proactive efforts of compliance can be an extremely powerful defense tool. Healthcare providers often have many different compliance programs in place that address Anti-Kickback and Stark Law requirements, such as regularly scheduled training, internal audit investigations, and different monitoring mechanisms. This shows how the organization took many different reasonable steps to prevent violations from happening.

FAQs

Q: Is the Stark Law the Same as the Anti-Kickback Statute?

A: No, the Stark Law and the Anti-Kickback Statute in Miami, Fl are two completely separate laws. However, they are often confused with each other, as they both deal with preventing inappropriate financial influences in healthcare. The Stark Law specifically prevents any physician from referring a patient to an entity they have a financial relationship with. Conversely, the Anti-Kickback Statute is a broader regulation that prohibits anyone from accepting money in exchange for a healthcare program referral.

Q: What Five Elements Must Exist for a Stark Law Violation to Occur?

A: There are typically five main elements that must be identified to know whether the Stark Law has been violated or not.

1. The case must include a referral from a designated health service, like Medicare.
2. The referral must be made by a physician.
3. There must be a financial relationship between the physician and the entity receiving the referral.
4. The case must not qualify for any exceptions.
5. There must be evidence that the referral was not just based on medical necessity.

Q: What Agency Is Tasked With Enforcing the Anti-Kickback Statute?

A: The Anti-Kickback Statute is enforced by the U.S. Department of Health and Human Services and the Department of Justice. The Department of Health typically is responsible for investigating any suspicion of kickback violations, while the Department of Justice will step in to prosecute the case and attempt to hold any alleged violators accountable. While it can be intimidating to face these large government entities, a defense lawyer can support you and defend your interests.

Q: What Is Considered a Kickback Under the Anti-Kickback Statute?

A: An official “kickback” is defined as any form of payment or incentive that is intended to influence someone, in this case, to start referring patients or services that are covered by a federal healthcare program. This can include anything as straightforward as cash payments to expensive gifts or even just simply receiving an unwarranted discount. This statute applies to both the party offering the incentive and the one benefiting from receiving it.

Contact The Law Offices of Barry M. Wax Today

If you have recently been accused of violating the Anti-Kickback Statute and/or the Stark Law in Florida and are unsure how to react, get in touch with us at The Law Offices of Barry M. Wax today. We have seen countless cases in this legal area and have the knowledge and experience necessary to provide you with a quality defense. While it can be intimidating to face these large government entities, our services can provide a strong defense and protect your rights in the process. Contact us today to schedule a consultation.