Healthcare providers are extremely cautious to not violate the anti-kickback statute by offering money for referrals. With ObamaCare, this issue might be eliminated.
The federal Anti-Kickback Statute (“Anti-Kickback Statute”) is a criminal statute that prohibits the exchange (or offer to exchange), of anything of value, in an effort to induce (or reward) the referral of federal health care program business. It has long been an extremely important tool that the government has utilized to curb fraud and abuse in the health care system. However, “one of the most potent resources that law enforcement has had at its disposal in the fight against health care fraud suddenly fell out of the government’s toolbox. In fact, while many in Congress and the mainstream media have focused on problems with the healthcare.gov website and the cancellation of policies that do not meet the requirements of the Affordable Care Act, another critical development has attracted considerably less attention: HHS Secretary Kathleen Sebelius’s announcement, in an October 30, 2013 letter to Representative Jim McDermott (D-Wash.), that insurance offered through the Affordable Care Act’s new health insurance exchanges do not constitute “Federal health care programs” and thus are not within the scope of the federal anti-kickback statute.” Article.
“The significance of Secretary Sebelius’s decision is underscored by the critical role that the anti-kickback statute has long played in the government’s ability to impose significant penalties and obtain massive recoveries in the health care industry.” Article. As the Affordable Care Act and its related regulations are still being developed and fine-tuned, Secretary Sebelius’ decision will likely be debated and modified in time. Stay tuned on this interesting topic.
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