Department of Health and Human Services' Electronic Health Record Incentive Program and Practice Fusion's compliance with the Anti-Kickback Statute
and HIPAA as it relates to certain business practices engaged in by Practice Fusion.
The Anti-Kickback Statute
restricts a pharmaceutical firm from offering or paying, directly or indirectly, any remuneration in the form of money or any other thing of value to motivate Medicare or ChampVA patients to purchase the company's drugs.
"As this case makes clear, companies must steer clear of violating the Anti-Kickback Statute
or risk being pursued."
Kristen also advises clients on day-to-day operational and compliance matters, including fraud and abuse laws, such as the federal Stark Law and Anti-Kickback Statute
, and the HIPAA; Medicare/Medicaid billing and reimbursement, licensure and accreditation; third-party payor issues; and state fee-splitting, fraud and abuse; and corporate practice of medicine laws.
The proposal, from the Department of Health and Human Services, would expressly exclude from safe harbor protection under the Anti-Kickback Statute
rebates on prescription drugs paid by manufacturers to pharmacy benefit managers, Part D plans and Medicaid managed care organizations.
Gary Lee, 58, both of Tulsa, for violations of the federal anti-kickback statute
and conspiracy to commit health care fraud.
* End the safe harbor to the Medicare Anti-Kickback Statute
. A safe harbor created for Group Purchasing Organizations (GPOs), which was supposed to lower prices, was extended to Pharmacy Benefit Managers (PBMs).
Herman added that the District Court judge apparently also required the plaintiff to show materiality, which the 1st Circuit emphasized in its opinion is required neither in a retaliation claim nor under the Anti-Kickback Statute
following an amendment in 2010.
ISSUE: In alleging violations of the Anti-Kickback Statute
, did a plaintiff meet the pleading requirements for a retaliation claim under the False Claims Act?
She has extensive experience in healthcare facility operations, and she is routinely called on to advise on transactions, contract negotiations, licensure and enrollment matters, clinical trial issues, and the intricacies of the Stark Law, Anti-Kickback Statute
, Health Information Privacy and Accountability Act (HIPAA), and Emergency Medical Treatment and Labor Act (EMTALA).
The federal Anti-Kickback Statute
prohibits the exchange of anything of value in an effort to induce the referral of business in federal health care programs.