Stark and Anti Kickback

STARK LAW & AKA LAW (Anti Kickback Law)

If you mix some mild antibiotic, a little dab of dog parasite medicine (Ivermectin) and a bit of this and that, your Rosacea may clear up.  You can’t get this at a drug store but I have a partner pharmacist who formulates this.  We can bill for it and most of the time it gets paid.  …. Is this legal ?  The profit is tempting.  Three dollars worth of chemicals, the cost of the tube and a few minutes labor and a $ 100 package exists.  Studies do show it may work.  Is it a Stark violation ?  Is it an AKS (anti kickback statute) violation ?  Is the science strong enough to justify the Rx ?  Would you prescribe it if you had no financial interest ?  Is this a Medical Board issue ?   There are state laws, medical board rules and insurance contract standards that apply but most dangerous are the federal laws that protect federal payor programs.  The complexity of laws and regulations often trip up an honest practitioner and our office knows the rules and protects you.

The Stark Law developed by our local Congressman, Pete Stark.  The Stark Law is also known as the Physician Self-Referral Act and unless you knew Pete Stark personally, that is the more descriptive name. The U.S. Code citation is 42 U.S.C. 1395 et seq..

As you read the Stark Law your head can spin. Can you make DHS Medicare referrals to a family member ?  What if it is a lithotripsy machine ? Is there an exception ? What about small towns when other treatment facility options are miles away ? Who is covered by this “physician” law ? Does it cover Doctors of Osteopathy, Dentists ? What about Pharmacists ? What about Chiropractors ?

Equally dangerous is the “AKS”. This is the federal anti-kickback statute. The Anti-Kickback Statute again focuses on referrals. This includes kickbacks for product, medical device, pharmaceutical and services kickbacks. An example are the recent string of arrests when a physician gave free samples of pain relief cream to a patient and then recommended a formulated product from a pharmacy. The physician had a complex scheme of reimbursement which the doctor’s attorney thought avoided Stark statute and Anti Kickback statute problems. The federal prosecutors disagreed.

The bottom line is this.  If you are a physician and you are making any money or have any relationship to other entities to which you refer – get legal advice. Bear in mind that with Stark law and other anti kickback statutes, our office is more conservative than many other practices.  Many of these businesses involve grey areas of law and it is our goal to put your safety and your license first.  We are not always right but we want our clients to sleep at night.  An example are the urologist / catheter arrangements where the MD’s seem to be seller and distributor of the catheters but fulfillment is by a third party (which makes the bulk of the profit).  These have often survived scrutiny but we use the “walk like a duck” approach and have unequivocally recommended against this grey area business arrangement.

If you are seeking a second opinion we can help.  If you are being sued or criminal charged for self dealing violations (or any type), Daniel Horowitz is a certified Criminal Defense Specialist (State Bar of California Board of Legal Specialization).

Call us: (925) 283-1863  or Fill Out our 1 Page Contact Form (click below)

 

Dan Russo

TRIAL LAWYER – DAN RUSSO

Dan Russo experienced jury trial attorney and criminal defense specialist featured at his law office in Vallejo california pink shirt and tie with law books from his vallejo office behind him.

Criminal Defense Specialist Dan Russo

707-644-4004

EXPERIENCE, SUCCESS & CRIMINAL DEFENSE EXPERTISE

Dan Russo is a trial lawyer extraordinaire !  Dan Russo been lead counsel has over 200 jury trials. 

Dan Russo is a Criminal Defense Specialist, certified by the State Bar of California Board of Legal Specialization for over 30 years.   Dan Russo has been a law school associate professor and a chapter reviewer for the leading criminal defense “bible” in California.

Physicians facing medical board accusations or medical-criminal investigations (e.g. medical fraud, Stark law violations) trust Daniel Russo to provide a defense that is well planned, forward thinking and aggressively applied.

Lawyers in Lafayette

Dan Russo works with a team of separate but affiliated lawyers at Lawyers in Lafayette.  Dan staffs each case with a custom team that is specifically designed to meet your needs.   If you have a business issue she has a paralegal with a high quality MBA.  If you have international issues, Daniel Horowitz has litigated cases throughout the world (including Ukraine, Israel, Cyprus, Canada, The Netherlands).

The team has two real estate brokers and two former top District Attorneys.   Whatever the issues are in your case, Carmela can lead a team that understands the issues and your concerns.

When Dan Russo takes your case you can be certain that the opposition knows that he will never back down from what is right.  With Lawyers in Lafayette on his team, Dan Russo has the advantage of incredible depth and experience to support his exceptional advocacy.

Trial Lawyer for Civil & Criminal Cases e, Call Dan Russo  (707) 644-4004

Dan Russo at press conference on high profile kidnap case

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