Tag Archives: anti-kickback statute

Concierge Medicine Article Series | The Anti-kickback Statute in Concierge and Cash-based Medical Practices

By John Fisher, JD, CHC, CCEP The Concierge and Cash-Based Medical Practice Article Series explores the evolving landscape of healthcare delivery models that prioritize patient-centered care, transparency, and direct financial relationships between patients and providers. Through this series, readers will … Continue reading

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THE OIG ADVISORY OPINION PATHWAY FOR CONIERGE AND CASH-BASED PRACTICES

For arrangements that are novel, involve significant financial investment, or present a unique structural profile without a clear safe harbor fit, the OIG Advisory Opinion process provides a mechanism for obtaining binding regulatory guidance. Under 42 C.F.R. § 1008.38, a … Continue reading

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SAFE HARBORS MOST RELEVANT TO CONCIERGE AND DPC PRACTICES

The regulatory safe harbors at 42 C.F.R. § 1001.952 provide the primary mechanism for structuring arrangements that would otherwise implicate the AKS. An arrangement that satisfies every element of an applicable safe harbor is protected from AKS prosecution. An arrangement … Continue reading

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WHY CONCIERGE AND DPC PRACTICES ARE NOT AUTOMATICALLY EXEMPT

The AKS exposure of a concierge or cash-based practice depends heavily on its specific structure and business relationships. The analysis differs materially across three broad categories of practice. A. Pure Cash / DPC Practice — No Federal Program Participation A … Continue reading

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Investment Interest in Radiation Therapy Anti-kickback Statute Settlement

By Fisher, JD, CHC, CCEP Radiation Therapy Referral Kickback Arrangements with Investors Overview A national operator of radiation therapy centers agreed to resolve allegations that it caused the submission of false claims by entering into investment-related arrangements that allegedly violated … Continue reading

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Treatment Center Plead Guilty to Anti-kickback Statute Violations Involving Alcohol and Drug Addiction Treatment Centers

By Fisher, JD, CHC, CCEP Substance Abuse Treatment Center Owners Plead Guilty in Fraud Scheme The Department of Justice recently announced that two owners of a licensed alcohol and substance abuse treatment provider pleaded guilty for their roles in what … Continue reading

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Free Transportation Services to Patients and Guests – When Is The Anti-Kickback Statute Violated?

Free Transportation Services and the Anti-kickback Statute Advisory Opinions, Safe Harbors, and other Guidance It is a fairly common practice for healthcare facilities, whether long term care facilities, hospitals, or large clinics, to offer free transportation services to patients and … Continue reading

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