The federal Anti-Kickback Statute (“AKS”) was enacted in 1972 and has been strengthened numerous times since then.  At its core, the AKS prohibits pay-for-patient referral schemes and is designed to make sure that decisions about government-funded medical care are made on the basis of sound medical judgment and not on the basis of personal financial gain.  The states have enacted similar anti-kickback laws.  These laws help to reduce the costs charged to the government programs, and prevent conflicts of interest effecting patient care.

Kickbacks may come in many different forms, from the most common referral and finder’s fees, to bonuses for increased purchases, discounted leases and equipment rentals, honorariums, research grants, speaker fees, above-market compensation, or freebies, like tickets to sporting events, travel and paid entertainment expenses.  The offer, payment, solicitation or receipt of any such monies or remuneration in exchange for a referral can be a violation of the Federal Anti-Kickback statute, as well as other federal and state laws and regulations.  In 2010, Congress amended the AKS to make clear that claims submitted to federally-funded healthcare programs in violation of the AKS automatically constitute false claims for purpose of the False Claims Act (“FCA”).  Therefore, health care providers who offer, pay, solicit or receive money, property or financial benefit of any kind to induce or reward the referral of patients or healthcare services payable by a government health care program, including Medicare or Medicaid, may be in violation of both the AKS and the FCA. 

If you believe someone has knowingly committed Medicare or Medicaid fraud by engaging in an improper kickback arrangement and you would like more information about how this may be the grounds for bringing a whistleblower lawsuit, the qui tam lawyers at Keller Grover LLP can help you.  The whistleblower lawyers at Keller Grover understand qui tam litigation, including the whistleblower protection provisions, and strive to achieve the best possible results for their clients.