"Upstream" Reach of the Federal Anti-kickback Statute

Home Blog "Upstream" Reach of the Federal Anti-kickback Statute

As Jeffrey Baird writes in a recent Medtrade article, the federal anti-kickback statute (“AKS”) makes it a felony to knowingly and willfully offer, pay, solicit, or receive any remuneration to induce a person or entity to refer an individual for the furnishing or arranging for the furnishing of any item or service reimbursable by a federal health care program (e.g., Medicare, Medicare Advantage, Medicaid, Medicaid Managed Care, TRICARE), or to induce such person to purchase or lease or recommend the purchase or lease of any item or service reimbursable by a federal health care program.

When it comes to DME, almost all suppliers understand that the AKS applies to scenarios where a federal health care program (“FHCP”) patient is directly involved.

In this article, Baird provides examples of the “downstream” reach of the AKS, meaning scenarios in which the person receiving “something of value” from the DME supplier refers (or arranges for the referral of) the FHCP patient to the supplier. 

Click here to read the full article from Medtrade.

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