BUSINESSAntikickback compliance is essential for contractsContract Language. By Steven M. Harris, amednews contributor. Dec. 10, 2001. All health care transactions should be closely scrutinized for fraud and abuse issues to ensure compliance with all applicable regulations and to minimize a physician's exposure to civil and criminal sanctions and penalties. Contractual transactions including executed and proposed employment, medical director, ancillary services, billing services and physician recruitment contracts should be of particular concern. The current climate of highly publicized fraud and abuse health care cases resulting in unprecedented verdicts, settlements, monetary penalties, and findings of civil and criminal liability has caused increased review and enforcement actions by both state and federal agencies. Physicians and their attorneys should consider the Medicare-Medicaid Anti-Fraud and Abuse Amendments, when drafting and negotiating any health care contracts. This column provides an overview of the antikickback statute and specific contract issues related to personal services and management contracts and rental of space and equipment. The antikickback statute prohibits an individual from knowingly and willfully paying remuneration (including any kickback, bribe or rebate) or receiving remuneration in return for referring a patient for the furnishing or arranging of a service covered by Medicare or Medicaid. It punishes not only the payer but also the receiver of prohibited remuneration. The statute was designed to prevent unnecessary utilization and to eliminate procedures or services that are not medically necessary; to foster patient choice and prevent arrangements that limit the freedom of the patient to choose a provider; and to reduce costs to federal programs.
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Copyright 2001 American Medical Association. All rights reserved.
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