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The Anti-Kickback Statute and False Claims Act

While remuneration for referrals may be a common practice in many businesses, under the Anti-Kickback Statute, it is considered a crime in regards to federal programs like Medicare and Medicaid. For example, if a doctor were to receive compensation from a medical supplies company for using that company’s products, both parties may be in violation of the Anti-Kickback Statute and subject to hefty fines and/or incarceration. The initial concern prior to the statue’s drafting was that doctors, under the influence of their benefactors, would begin providing unnecessary care so as to receive compensation. The federal government enacted this statute as they believe it serves the best interests of patients and their tax dollars.

Often mentioned alongside the Anti-Kickback Statute, the False Claims Act allows individuals who have information on health care fraud to file a qui tam lawsuit. These individuals, commonly referred to as “whistleblowers” are protected by the government and are eligible for fifteen to thirty percent of the government’s recovery. With False Claim Act penalties costing up to three times the government’s loss, plus an additional $11,000 per claim, whistleblowers have good incentive to report violations. However, should the Department of Justice not decide to follow through with litigation, the whistleblower can pursue litigation on behalf of the government.

For more information or to discuss an Anti-Kickback or False Claims Act issue, call our Philadelphia employment lawyers at Sidney L. Gold & Associates at 215-569-1999 or contact us online.

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