Cooper v. Pottstown Hospital is another case where a dissatisfied party is attempting to use the federal Anti-Kickback Statute or the Stark Law in litigation arising out of the contracts to which they were willing parties at one time. Usually, breaching parties have used this argument as a defense, claiming that the contracts were illegal,
Anti-Kickback Statute
OIG Rejects Specialty Pharmacy Request to Pay “Per-Fill” Payents to Retail Pharmacies
By Michael Cassidy on
Posted in Compliance
In OIG Advisory Opinion 14-06, the Office of Inspector General (OIG) concluded that payment by a specialty pharmacy to a retail pharmacy on a “per-fill” basis for services provided by the retail pharmacy could violate the Anti Kickback Statute and Civil Money Penalty provisions.
The specialty pharmacy, as the requestor, proposed to pay retail…
OIG Suspicious of Marketing Arrangements
By Michael Cassidy on
Posted in Fraud - Stark
In OIG Advisory Opinion No. 11-17, the OIG has broadcast its suspicion of percentage based marketing arrangements.
The request seeks the OIG’s “no action” letter on a proposal by which a company will provide consulting and marketing services to physician practices. The services would be designed to review patients’ files and identify opportunities to provide allergy…
CMS Issues: Stark Voluntary Self-Referral Disclosure Protocol
By Michael Cassidy on
Posted in Fraud - Stark
Section 6409 of the Patient Protection and Affordable Care Act (PPACA) required CMS to develop a Medicare Self-Referral Disclosure Protocol (SRDP) to facilitate the resolution of potential Stark violations. The SRDP was published on September 23, 2010 with two caveats:
1. Despite the fact that potential violations or situations might violate more than just the Stark…