People working in the medical or health industry often take money from the government for various reasons, whether it be through Medicare or Medicaid. However, a person cannot give kickbacks to anyone to get that person to perform any type of medical service. An example would be a doctor giving kickbacks to anyone who is sending them patients.
A violation of the anti-kickback statute is not to be taken lightly. It could lead to both civil and criminal charges. For instance, if someone is found to be receiving kickbacks related to government aid, they can face serious criminal charges.
An investigation is usually conducted by an entity working for a branch of the government. It is typically civil to start, and then the government can also try to prosecute the person federally. Our federal criminal defense lawyers provide a review below.
Who is Liable in Anti-Kickback Investigations?
Who is generally under investigation or potentially liable in these kickback scenarios that the government is investigating? Anyone can be liable in these cases; patients can be liable, and doctors can be liable.
People who work for doctors can be liable. Often, the low-level employees give information about the physicians or any type of health care fraud activity. The prohibition against the exchange or offer of anything of value in an effort to induce or reward a referral of business reimbursement by federal health care programs is what we are talking about when we refer to anti-kickback statutes.
What are 'safe harbors' in the context of the anti-kickback statute? These are provisions that protect individuals who are not engaging in illegal financial activities but are allowed to receive certain payments. If you fall within these safe harbors, you are shielded from any allegations of fraudulent financial practices.
The bottom line is everything has to be run through the federal government when it relates to payments of Medicare, Medicaid, or anything that the government is giving in relation to health care. You are safe as long as whatever you are doing is within the realm of what is permitted by the statute.
How Can I Be Liable If I Didn't Know About the Kickbacks?
Even if you, as a CEO, were unaware of any kickback activities within your business, you can still be held liable. If your company is found to be defrauding the government through kickbacks or any other fraudulent means, you will be held civilly responsible, regardless of your knowledge of the situation.
Criminal charges will require more knowledge of whether you knew or reasonably should have known under the circumstances. If a person is a CEO and intricately involved in the business, they should know what the business is doing.
Your business is doing something illegal or fraudulent as it relates to health care benefits. You are going to be held responsible for that under the concept that you reasonably should have known. You must check out what your business is doing, how it is making money, and whether it is complying with federal regulations.
Should I Contact Law Enforcement If I Know About Kickbacks?
I'm aware of a kickback situation at the company I work for. Should I go directly to the authorities? If your company is taking kickbacks, consider going to the government and explaining that you just found out about this and don't want to be involved.
If you are considering reporting a kickback situation to the government, it's crucial to seek legal guidance. You want to ensure that you are not unfairly prosecuted and secure some form of immunity agreement.
Hedding Law Firm, a federal criminal defense attorney located at 16000 Ventura Blvd #1208, Encino, CA 91436, is here to help. Call (213) 542-0994 for a free case evaluation and put your legal concerns to rest.
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