In 1972, U.S. Congress passed Federal anti-kickback laws to protect patients from medical referrals based upon the health care provider receiving a kickback or financial incentive, rather than on medical necessity. In general, kickbacks include the practice whereby a person or business pays someone to find new clients or referrals and/or pays that person a percentage of the increased transactions resulting from those referrals.
Michigan’s self-referral laws, similar to federal Stark Laws, address situations in which the healthcare provider has a business interest in the facility to which he/she makes referrals.
Michigan’s Anti-Kickback Statutes regularly affect the daily practices of Michigan’s health care professionals, such as physicians, pain management specialists, and pharmacists. The business of healthcare generates frequent referrals back and forth between providers of goods and services, and sometimes these relationships provide for unlawful financial incentives.
Every doctor or related health care practitioner should understand whether their inbound and outbound referral patterns are making them susceptible to liability under the anti-kickback laws because the penalties for non-compliance are severe.
Kickbacks take many different forms. Some are obvious, like a doctor who accepts cash in exchange for referrals. Others are more subtle, such as a hospital giving a physician reduced office rent in exchange for the informal agreement to refer patients to the hospital. It is surprisingly easy to unintentionally run afoul of Michigan’s anti-kickback laws, and end up with Qui Tam and whistleblower actions because of it.
The FBI and state authorities actively enforce the anti-kickback laws. Even unintentional anti-kickback violations are prosecuted because the statutes do not require willful or knowing conduct.
Given the severe penalties under Michigan’s anti-kickback laws, healthcare professionals and providers should work with an experienced health care attorney to ensure that their referral relationships are legitimate and do not lead to exposure under the law.
For 35 years, our healthcare lawyers at Chapman Law Group have been helping health care practitioners in Detroit, Dearborn, Ann Arbor, Troy, Grand Rapids and all across Michigan understand and comply with the anti-kickback laws, false claims matters, and Stark Law violations.
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