The Stark Law is one of the primary mechanisms the government utilizes to remove the financial incentive from physician’s referrals. In particular, the Stark Law prohibits a physician from making a referral to an entity for designated health services that are reimbursable by Medicare in the event the physician has a financial relationship with the entity. [...]
The Anti-Kickback Statute is one of the major tools the Federal government uses in enforcing fraud against Federal healthcare programs. In addition, it happens to be one of the oldest mechanisms for enforcement. Generally, the Anti-Kickback Statute is a criminal statute that prohibits a person or entity from exchanging, or offering to exchange, anything of value, [...]
Increasingly, chiropractors have been in the headlines facing charges of Medicare fraud. Although Medicare fraud is not new, one of the largest problems facing chiropractors throughout the country is the increased enforcement by the federal government when it comes to healthcare fraud. For example, recently a chiropractor was sentenced to prison for a $3 million [...]
On July 08, 2015, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that updates payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2016. This year, CMS is proposing a number of new policies, including several that are [...]