Anti-Kickback Law

Because the Stark Act is legislation enacted to combat kickbacks to physicians for referral of lab tests (Elsenety, 85 Fed. Appx. 405, 409), its violation brings into play the Medicare anti-kickback statute.  United States ex rel. Thompson, 125 F.3d 899, 901 (5th Cir. 1997).  The Medicare anti-kickback statute prohibits (1) the solicitation or receipt of remuneration in return for referrals of Medicare patients, and (2) the offer or payment of remuneration to induce such referrals.  42 U.S.C. § 1320a-7b(b). See also United States ex rel. Thompson, 125 F.3d at 901.  The Stark and Anti-Kickback Acts ensure the quality of patient care and deter abuse of federal health care programs by proscribing certain conflicts of interest that arise when third-party payors cover the cost of treatment.  United States ex rel. Kosenske v. Carlisle HMA, Inc., 2007 U.S. Dist. LEXIS 84294, 16-17 (M.D. Pa. 2007).  The Stark Act prevents a physician’s personal financial interests from influencing the type and quality of care that patients receive. Id. The Anti-Kickback Act reinforces the policies underlying the Stark Act through criminal sanctions. Id.

Courts have held that violations of Anti Kickback Statute and Stark Law can be pursued under the False Claims Act, since they would influence the Government’s decision of whether to reimburse Medicare claims. See, e.g., United States ex rel. Barrett v. Columbia/HCA Healthcare Corp., 251 F. Supp. 2d 28, 33 (D.D.C. 2003) (“Compliance with AKS and Stark laws would affect the government’s decision to pay.”); United States ex rel. Ortega v. Columbia Healthcare, Inc., 240 F. Supp. 2d 8, 13 n.5 (D.D.C. 2003) (“Compliance with AKS and Stark Laws is a condition for reimbursement under Medicare, and [defendants] impliedly certified compliance with these laws in submitting claims to Medicare.”).

Inside Anti-Kickback Law