Anti-Kickback Law, Fee-Splitting & Stark Law

Fraud and abuse issues permeate healthcare regulatory concerns.

Our healthcare attorneys regularly counsel clients on compliance with Federal and State anti-kickback statutes. Our anti-kickback lawyers provide in-depth guidance and analysis to healthcare providers on issues arising out of federal and state self-referral laws.

Whether you require a brief explanation or a full-blown analysis and legal opinion, we will review federal self-referral (“Stark”) and anti-kickback law, and laws and regulations governing self-referral, kickbacks, and fee-splitting in California, Massachusetts, New York, Washington, D.C., and other relevant states.

We can help clients navigate the increasingly complex fraud and abuse laws. We structure and document transactions and design policies and procedures for compliance with the fraud and abuse rules and counsel clients on how to properly unwind transactions and ventures.

In addition to Stark and anti-kickback legal issues, fee splitting is a common legal issue faced by health care providers and businesses in compensation situations, particularly in the presence of percentage-based fee arrangements. Violations of fee-splitting statutes can create serious issues for all parties involved. For example, there may be illegal splitting of fees between MD or other relevant health care practitioner, and the Center or Medical Spa).

The federal Office of Inspector General (OIG) actively investigates violations of Stark self-referral provisions and the anti-kickback laws. Among other documents, the OIG has issued several fraud alerts to govern investigatory decision-making. One of the key areas of interest involves joint ventures that fail compliance with federal fraud and abuse law. State agencies are also stepping up enforcement in line with federal priorities. For example, in California, Business & Professions Code Section 650 addresses kickbacks and fee-splitting. California, Florida, Massachusetts, New York, and most other states address both self-referral and fee-splitting. Legal research into statutes, state-specific attorney general opinions, and cases is necessary to properly structure compensation and other business arrangements in ways that respect relevant legal prohibitions.

It is critical to conduct an analysis of Stark, anti-kickback and fee-splitting issues to look for illegal business arrangements and advise on a more compliant compensation agreement. Our law firm can prepare a Memorandum analyzing Stark, anti-kickback and fee-splitting issues and outlining compliant compensation arrangements.

We will also analyze federal and state anti-markup issues for our diagnostic imaging clients.