Physicians need to be wary of “creative billing” practices

On Behalf of | Jan 25, 2023 | Firm News

As a physician, you want what is best for your patient. You build close relationships with them and work hard to accommodate them in all ways possible, even in paying their bills. Despite the fact that the services you provided to a patient were medically necessary, you could still violate the Anti-Kickback Statute (AKS). The AKS strictly regulates physician compensation when payments are supposed to be reimbursable by federal health care programs.

You can unknowingly violate the AKS

It is illegal for a physician to accept anything of value in exchange for any product and or service that should have been paid for by government programs like Medicaid. Below are examples of actions that may violate the AKS:

  • More affordable office rent for your clinic
  • Expensive meals from medical representatives
  • Luxurious vacations from drug companies
  • A watch or car from patients or business clients
  • Cash higher than the fair market value

However, physicians can offer free and even discounted services to their patients with no insurance, but officials can still view the waiving of copayment as a breach of statutory duty.

Violations of the AKS are not only civil offenses like the Physicians Self-Referral Law; these are criminal offenses. Your intent may have been good, but it does not always look that way on paper.

Facing AKS charges requires legal help

Any breach of the AKS highlights that it is an intent-focused crime; however, with penalties as high as $50,000 and 5 years of jail time, the government will not go easy on the defense. With the proper guidance, the legal system can ensure that your business will not face any unnecessary infractions.