Master Stark and Anti-Kickback Statute (AKS) to Protect from Costly Penalties

Event Materials (Key Required)

Course Description

If you believe you understand Stark regulations, think again. Even the smallest errors could put your practice at risk of infringing these regulations, as the government has made it harder and harder to identify what exactly qualifies as a violation. Last year, Stark Law settlements topped $12 million, setting a new government record, and this figure is predicted to rise. Maintaining compliance with Stark and Anti-Kickback regulations is not only crucial, but also essential given the increased level of scrutiny.

Healthcare attorney Michael R. Lowe, JD, Esq., will provide you the precise steps and actions you need to follow to protect your practice from Stark and Anti-Kickback violations and the costly penalties. You can be confidently stepping aside these regulatory issues.

Learning Objectives

• To understand what legally counts as remuneration
• To be able to Differentiate free screenings as a benefit from those designed as “inducements”
• To know the Quickly and accurately identify acceptable gifts those you should never take
• To learn how to follow statutory safe harbors to protect your practice
• To stop contract arrangements from making you a target for prosecutors
• To understand the new Eliminating Kickbacks in Recovery Act (EKRA) statute
• Correctly self-disclose mistakes and minimize damage to your practice
• To understand when it’s OK to waive copays and when it’s not
• To know what hardship documentation you must include to comply

Areas Covered in the Session

• Background/Applicable Law
• Federal Stark Law (42 U.S.C. § 1395nn)
  • Physician
  • Referral
  • Medicare/Medicaid Patient
  • Designated Health Services (Partial List)
  • Entity with which the Physician has a Financial Relationship
  • Penalties
  • Per Se Statute/No Intent Required to Violate
• Types of Remuneration implicated by the Stark Law
• Stark Law Exceptions
• Federal Anti-Kickback Statute
• Safe Harbors (Partial List)
• Penalties for Anti-Kickback Statute
• Elements
• Current Safe Harbors
• Criminal prosecutions under the antikickback statute – telemedicine fraud
• OIG Guidance on the Anti-kickback Statute
  • Advisory Opinions from the OIG regarding Remuneration
  • OIG Fraud Alerts
  • Special Advisory Bulletins
  • Compliance program guidance and other materials
• Actionable Anti-Kickback Statute Compliance
• The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act)
• The Eliminating Kickbacks in Recovery Act (EKRA)
• EKRA Exceptions
• Federal False Claims Act
  • Qui Tam Provisions
  • Penalties - $11,500 Maximum Fine per Occurrence
  • Tainted Transaction Theories/Claims
• Current Enforcement/Hot Issues
  • Physician-Specific Risk Areas
  • Evaluation of Incident-To Services
  • Eye Surgeries
  • Place of Service/Location of Service Errors
  • Review of E&M Services During Global Surgery Periods
  • Psychiatric Services Provided in Inpatient Settings
  • Advanced Imaging Services in Physician Offices
  • Violations of Assignment Rules by Medicare Providers
  • Long Distance Physician Claims Associated with Home Health and Skilled Nursing Facility Services
  • Incident-To Billing Services
• Prevention of Billing/Coding Errors
• Conducting Internal Investigations/Responding to Government Scrutiny/Intrusion
• Strictly Follow the Incident-To Billing Requirements

Suggested Attendees

• Healthcare Executives
• Physicians and Non-Physicians Practitioners
• Medical Doctors
• Osteopathic Physicians
• Podiatric Physicians
• Chiropractic Physicians
• Physician Group Practices
• Ambulatory Surgical Centers
• Hospital Risk Managers and Administrators
• Free-Standing Diagnostic Imaging Centers
• Independent Lab
• Skilled Nursing Facilities
• Physician Therapy Practices
• Licensed Health Care Risk Managers
• Compliance Officers and Managers
• Practice Administrators and Managers
• Individual Physicians
• Billing Coordinators and Managers
• Healthcare Providers
• IDTF Administrators
• Healthcare Billing Consultants
• Medical Billing Companies
• Independent Lab Owners/ Administrators

About the Presenters

Michael R. Lowe, JD, Esq., is board certified in health care law by The Florida Bar and is an AV rated attorney. His practice focuses on all aspects of business, corporate, transactional, litigation, regulatory, operational and administrative matters in the health care law arena. Emphasizing the representation of physicians and physician group practices, Mr. Lowe regularly represents clients in litigation, medical records and HIPAA privacy regulations issues, managed care contracting and reimbursement matters, the preparation, review and negotiation of physician employment agreements, Medicare/ Medicaid fraud and abuse prevention, federal Stark Law matters and analysis, defense and reimbursement issues, ACA matters, medical staff privilege cases, professional licensure and disciplinary actions, voluntary self-disclosure cases, physicianhospital contracts, compliance plan development, and health care regulatory analysis and counseling matters. Mr. Lowe’s practice also includes the representation of hospital medical staffs, IPAs, ambulatory surgery centers, durable medical equipment providers, diagnostic imaging centers, hospitals, long-term care facilities and other health care professionals and providers.

Licensed in both Florida and Georgia, Mr. Lowe is a member of the health law sections of the Florida Bar, Georgia Bar and American Bar Associations. Additionally, he is a member of the American Health Lawyers Association. Mr. Lowe was evaluated by his peers as a “preeminent” attorney, and awarded the “AV” rating by Martindale-Hubbell. The “AV” rating identifies a lawyer with preeminent expertise, experience, integrity, and overall professional excellence.

Mr. Lowe has written numerous articles on a variety of health law issues of concern to physicians, practice managers, and health care organizations throughout the country. He is a frequent lecturer on various health care law topics for local, state and national groups. Mr. Lowe received his B.S. degree in history from the United States Naval Academy and his M.A. degree in national security studies from Georgetown University, and is a former naval aviator and Desert Storm veteran. Mr. Lowe graduated summa cum laude from the University of Alabama School of Law, where he earned his J.D. degree.

Additional Information

System Requirement:

• Internet Speed: Preferably above 1 MBPS
• Headset: Any decent headset and microphone which can be used to hear clearly

For more information, you can reach out to the below contact:

Toll-Free No: 1-302-444-0162

Email: care@skillacquire.com 

Purchase Order Form - Click Here to download PO form. 

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