Things Every Healthcare Practice Needs To Know About The Anti-Kickback Statute: Part 1

things every healthcare practice needs to know about the anti-kickback statute

If you’re in healthcare, chances are you’re quite familiar with the Anti-Kickback Statute. It’s that federal regulation that’s got your practice’s physician liaisons sweating with every delivered gift basket. Technically speaking, the AKS prohibits “the offering, solicitation, or acceptance of any type of gift or remuneration in exchange for rewarding referrals for federal healthcare program business.” Sounds intense, right?

One of the biggest issues with the Anti-Kickback Statute is that it’s so broad. It’s been around for over 40 years, and physicians today are still struggling to understand exactly what it is and how it affects their practice. There’s not enough time in the world for me to go over all the different nuances, but here are 7 things every healthcare provider should know about the Anti-Kickback Statute, split into two separate posts so you’re not overwhelmed at once. In this first post, we’ll be covering the basics.

1. Understand its origins.

The Anti-Kickback Statute isn’t exactly new to the market. It was enacted by congress in 1972 as an amendment to the Social Security Act.

2. Familiarize yourself with why the regulation was originally put in place.

The AKS was put in place primarily to address the many loopholes in the Social Security Act. These loopholes made it easier for organization to defraud healthcare programs through the use of kickbacks, and also made it incredibly tough to prosecute offenders.

The primary goal of the AKS was to “close the SSA loopholes by providing clearer standards through which to prosecute fraudulent healthcare organizations”. Their way of accomplishing this? Spelling out offences relating to healthcare referrals and putting clear penalties in place for those who violated the law.

3. Be able to recite the basics.

The AKS is a complicated and fairly wordy document, but at the end of the day there are a few general concepts everyone in healthcare needs to be aware of. Long story short, the AKS makes the following three things illegal:

·      A physician or health service provider claiming reimbursements from Medicare or Medicaid for payments made in kickbacks

·      A physician/health service provider asking for compensation in return for referring patients who are on Medicaid or Medicare

·      A health service provider to compensate a physician or service provider for referring Medicare or Medicaid patients to them

The AKS can be confusing, but understanding the basics of this statute will go a long way towards keeping yourself protected. Next time we’ll dive a little deeper into four more AKS basics you should familiarize yourself with.