PHILADELPHIA HEALTH CARE LAWYERS: ANTI-KICKBACK COMPLIANCE

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Sidney L. Gold

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For as long as there have been businesses, there have been schemes to tip the competitive scales. However, kickbacks tip the scales in ways that are less-than-fair. Such schemes become a serious issue in the medical profession because they inflate costs. Recent decades have seen a sharp increase in medical costs. The federal government believes that a key factor in these increases involves fraud and waste, including kickback schemes. U.S. regulatory agencies are increasing efforts to identify physicians and healthcare companies engaging in such schemes. Many doctors and hospitals are seeking ways to avoid direct or indirect implication in kickback schemes.

Understand the law
One of the best ways to avoid running afoul with anti-kickback laws is to learn what constitutes a kickback. This can be accomplished by speaking with a health care lawyer at Sidney L. Gold & Associates before the need for a defensive strategy. Another way to learn more is to contact the Office of Inspector General of the U.S. Department of Health and Human Services. This agency offers compliance program guidance to health care providers.

Create office policies with a focus on compliance
Next, your office will want to implement a compliance program. Establish limits to what may or may not be accepted from solicitors and make sure that employees are trained accordingly. The HHS-OIG advises that a gift that has more than nominal value or is used to directly influence the decision-making of an individual in the practice is considered a kickback. Thus, while a sales rep bringing donuts to the office may be acceptable, taking the decision-maker to a fancy restaurant may not. In most cases, physicians are wise to reject any gift, thus avoiding the slightest hint of impropriety.

Do not make special offers
Avoid procedures that could improperly influence medical service choices. An example would be to routinely waive copayments, coinsurance, and deductibles for patients. The key is routine. It is fine to occasionally help a patient who is having financial difficulties, but if this practice is used to draw in patients, it becomes a form of kickback.

Finally, the law allows for a variety of safe harbors by which a physician practice may engage without being reviewed for non-compliance of anti-kickback laws. These include the offering of discounts, warranties, waivers of beneficiary coinsurance, referral services, and more. The best way to ensure compliance is to discuss office financial practices with a knowledgeable and qualified health care lawyer.

Philadelphia Health Care Lawyers at Sidney L. Gold & Associates, P.C. Help with Anti-Kickback Compliance
The Philadelphia health care lawyers at Sidney L. Gold & Associates, P.C. help physicians in Pennsylvania, New Jersey, and New York stay compliant with anti-kickback laws. Do not wait until investigators arrive at your practice asking questions. Contact us online or call today 215-569-1999 to arrange a confidential consultation in our Philadelphia office.

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