Federal Anti-Kickback Statute: An overview by Anti-Kickback Defense Attorney

Almonte Law

What is the Anti-Kickback statute?

The anti-kickback statute makes it a crime to knowingly and willfully solicit, receive, offer, or pay “any remuneration” to induce business that is reimbursed under a federal health care program.

The anti-kickback statute prohibits a person from either paying or receiving something of value to induce or reward the referral of business.

Compliance with the anti-kickback statute is a condition of payment for any claim submitted to a federal health care program.

What is soliciting or receiving a health care kickback?

Under Title 42, U.S.C Sec. 1320a-7b(b)(1), the government must prove that a defendant asked for or received any remuneration (something of value) directly or indirectly. Further, the government must prove that the payment asked for or received was in return for:

(A) in return for referring an individual to a person for the furnishing or arranging for the furnishing of any item or service for which payment may be made in whole or in part under a Federal health care program, or

(B) in return for purchasing, leasing, ordering, or arranging for or recommending purchasing, leasing, or ordering any good, facility, service, or item for which payment may be made in whole or in part under a federal health care program.

The government must prove that the defendant did so knowingly and willfully. Under the Affordable Care Act (ACA), willfully in this statute does not require proof that the defendant knew of the existence of, or intended to violate, the specific statute.

What is offering or paying a health care kickback?

Under Title 42, U.S.C Sec. 1320a-7b(b)(2), the government must prove that the defendant knowingly and willfully offered to pay or paid a remuneration (including any kickback, bribe, or rebate) directly or indirectly to induce such person to:

(A) to refer an individual to a person for the furnishing or arranging for the furnishing of any item or service for which payment may be made in whole or in part under a federal health care program, or

(B) to purchase, lease, order, or arrange for or recommend purchasing, leasing, or ordering any good, facility, service, or item for which payment may be made in whole or in part under a federal health care program.

Are there exceptions to soliciting, receiving, paying, or offering to pay?

There is no definitive answer, and each case is fact specific. However, Under Title 42, U.S.C Sec. 1320a-7b(b)(3) outlines exceptions. You should always consult with an anti-kickback defense attorney to determine the merits of your case.

What is the punishment for violating the anti-kickback statute?

Fine of not more than $100,000.

Imprisoned for not more than 10 years, or both.

What do I do if I am under investigation for violating the anti-kickback statute or have been charged with violating the anti-kickback statute?

Contact an anti-kickback statute defense attorney. Contact a lawyer with actual experience in understanding these crimes. Robert Almonte, a former health care fraud prosecutor, understands these crimes, how the crime is charged, how the crime is investigated and more importantly, Robert Almonte can identify both the strengths and weaknesses of each case.

Federal investigations have no limits. The Department of Justice has infinite resources to investigate. Robert Almonte, a former federal (DOJ) prosecutor handles the most difficult cases and possesses the expertise to successfully navigate these sensitive and high-stake situations.

Don’t risk your professional license, reputation, or freedom- call Robert Almonte for a private and discreet consultation.

The information provided on this website is for general information purposes only. Nothing on this site should be taken as legal advice.