The United States government is watching carefully for medical providers who violate the federal Anti-Kickback Statute, as it considers fraudulent referrals a direct threat to taxpayer dollars and patient trust. If your hospital, clinic, or practice is not immaculate in its financial dealings, you may be tempting an investigation, one which could escalate to criminal charges and lead to the end of your career, hefty fines, and incarceration without the aid of a skilled federal healthcare fraud attorney.
If the Department of Justice or the Office of Inspector General has any reason to believe that your financial relationships are not above board, you can expect audits and subpoenas. Unfortunately, many people think that these issues are merely administrative errors and therefore insignificant. However, when federal agents have evidence of an illegal referral arrangement, those involved can get hit with felony criminal charges that threaten their future and their freedom.
At Aaron L. Wiley Law, P.C., our federal healthcare fraud lawyers have seen firsthand the consequences of administrators, pharmacists, and doctors deciding to overlook the Anti-Kickback Statute, along with other healthcare compliance violations, and pray that no one notices. If one thing is certain, the government is resolute in its efforts to eliminate every form of disguised referral fee, bribe, and kickback.
The Anti-Kickback Statute
In 1972, the Anti-Kickback Statute was federally enacted. Its goal was to prevent the solicitation, payment, offering, or receipt of any money or items of value in return for referring patients for services paid for by Medicaid, Medicare, or another federal program. Anyone found in violation of this law could face criminal penalties, up to and including five years in jail, and substantial fines. Judges who notice repeated or multiple violations can tack on additional sentences, usually in conjunction with additional federal charges. A single shady referral arrangement can invite severe legal consequences.
The Trend of Perks and Referral Fees in Healthcare
Many medical providers think that modest “consulting fees” and small perks for marketers and physicians are safe, but this is not always the case. Even an offer of cash, an expensive vacation, or a fancy dinner could be seen as a kickback if it is in any way connected to federal healthcare referrals. The federal government takes a very dim view of providers who exploit the system. Even if you were unaware of the illegality of the transaction, prosecutors will claim that you willfully broke the law.
A lot of medical professionals feel that taking small bonuses or referral fees is okay because “everyone does it.” Others see giving money in exchange for patient referrals as blatantly dishonest, so they avoid engaging in any activity that might look suspicious. Just as many large healthcare chains have paid huge settlements arising from dubious referral practices, many smaller clinics have managed to avoid serious trouble by exercising extreme caution.
Do not fall into the trap of thinking that small gifts will keep you off the government’s radar. Even a modest perk can set off a criminal investigation, especially if you can’t prove that those perks are not related to any patient referrals. If you have been contacted by the Office of Inspector General or any other government agency about Medicare Anti-Kickback violations, contact an experienced federal healthcare fraud lawyer right away.
Defending Healthcare Fraud Cases
If you have been charged with a Medicare Anti-Kickback violation, our firm can protect your rights. The first step is gathering any evidence that was collected by prosecutors, then picking it apart by searching for procedural errors and inconsistencies. Did they overlook evidence that showed your arrangement was lawful under a safe harbor? Were your records seized without a warrant? Any sign of government overreach can turn the case in your favor.
Where possible, our federal healthcare fraud attorneys will demonstrate that you acted in good faith by emphasizing your efforts to remain compliant. For example, we may highlight training materials and policies that were enacted to prevent misconduct, or argue that your arrangement is covered by an advisory opinion or a legal exception. For instance, the OIG Safe Harbors outline specific exceptions for lawful business practices. If your arrangement meets the requirements for a safe harbor, it could negate any potential criminal liability.
Our objective is to get the charges against you dismissed or reduced, or to reach an agreement that does not involve you serving time. That could mean you have to pay a hefty settlement or fine, but it also means you live to fight another day.
Talk to a Federal Healthcare Fraud Lawyer
In order to justify their existing kickback arrangements, many medical professionals make comments like “That’s how it’s always been done.” However, by the time you realize you are under investigation, the government has already built its case against you, questioned your staff, and possibly even frozen your bank accounts. Earning a spot on the Office of Inspector General’s exclusion list by way of a felony conviction will jeopardize your ability to run an otherwise successful practice. Fortunately, with an experienced federal healthcare fraud attorney on your side, you still have options.
If you suspect your referral practices are questionable or that you’ve raised red flags related to Medicare Anti-Kickback violations, you need to take immediate action. If you wait until you receive a subpoena, you may have lost the opportunity to control the narrative. Healthcare compliance violations carry serious consequences. If federal authorities are targeting you, we can help. To schedule a free and confidential case review with a member of the Aaron L. Wiley Law, P.C. federal healthcare fraud defense team, call (254) 566-3860 or reach out through our online contact form.