South Florida Hospital News
Tuesday October 24, 2017
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May 2013 - Volume 9 - Issue 11

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Compliance with Self-Referral and Anti-Kickback Laws – a Practical Guide

Physicians and health care professionals must comply with a number of federal and Florida laws restricting patient referrals and financial relationships among medical practices, hospitals, and other businesses. A failure to comply with these laws can result in severe consequences, such as disciplinary actions, fines, exclusions from participation in state and federal health care programs, as well as civil and criminal penalties.
 
As an attorney with almost 20 years experience practicing health law, I answer questions every day concerning how to comply with, and how to handle the consequences of violating these laws. Over the years, I recognized the need for a practical guide for health care professionals to help them understand the laws governing their practices. In response to that need, I co-authored with Alan S. Gassman, Esq. the book, Kickback and Self-Referral Laws for Florida Physicians.
 
The book is a practical guide that focuses on the most important laws affecting the daily practices of Florida health care professionals, medical office managers, and physician advisors. It summarizes and educates the reader – in plain everyday language – on the laws governing their practices. The book covers laws such as:
 
• The Federal Physician Self-Referral Law (Stark Law)
A “strict liability” statute generally prohibiting a physician from making patient referrals for Medicare or Medicaid covered “designated health services” to another entity that the physician or an immediate family member has a “financial relationship” with, unless specific exceptions apply.
 
• The Florida Patient Self-Referral Act
This act prohibits the patient referral by a health care provider or immediate family member who has an ownership or investment interest in the entity providing the service or treatment, unless specific exceptions apply. (The book also provides a comparison chart of the Federal and Florida Self-Referral laws for easy reference).
 
• The Florida Patient Brokering Act
This act makes it a third-degree felony to participate or aid in patient brokering. It prohibits a health care provider or facility from paying or receiving any remuneration (i.e. commission, bonus or rebate) in exchange for referrals, regardless of the source of payment for the applicable service or product.
 
• The Federal Anti-Kickback Statute
This statute imposes criminal penalties against any person who willfully pays, offers, solicits, or receives any “kickback” to induce the referral of items covered by Medicare or Medicaid. “Kickback” is construed broadly and could include giving away sports tickets or paying for dinners, unless a specific “safe harbor” applies.
 
• Prohibitions on Fee-Splitting
Various Florida fee-splitting prohibitions prevent physicians, medical providers, and institutions from dividing revenues or profits in exchange for referrals, unless specific exceptions apply.
 
The book summarizes and explains the laws and guides the reader through a number of questions and situations to consider under each law.
 
It uses a “caution sign” to point out areas of law that often pose a trap for the unwary, making it easier for health care professionals to understand which areas to focus on, in order to better be in compliance with the laws.
 
Kickback and Self-Referral Laws for Florida Physicians is available on Amazon.com.
Lester Perling, a partner with the Fort Lauderdale office of the statewide law firm, Broad and Cassel, can be reached at (954)764-7060 or lperling@broadandcassel.com. Law Clerk Christina Lehm, who is attending NSU Law School, contributed to this article.
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