According to the U.S. Department of Health & Human Services OIG(office of inspector general), the Anti-Kickback Statute was originally enacted in 1972 to protect patients and federal healthcare programs from fraud and abuse. The federal Anti-Kickback Statute (“Anti-Kickback Statute”) is a criminal statute that prohibits the exchange (or offer to exchange), of anything of value, in an effort to induce (or reward) the referral of federal health care program business.

Stark Law:
Physician self-referral is the practice of a physician referring a patient to a medical facility in which he has a financial interest, be it ownership, investment, or a structured compensation arrangement. Critics of the practice allege an inherent conflict of interest, given the physician's position to benefit from the referral. They suggest that such arrangements may encourage over-utilization of services, in turn driving up health care costs.

Read more from this link:
https://oig.hhs.gov/compliance/provider...training/.../starkandakscharthandout508.pdf

Hi,

Thank you for sharing the link. Very interesting topic Hetal. The Federal Anti-Kickback Statute and the Stark Law are often confused because both laws deal with remuneration related to improper referrals.The Anti-Kickback Statute is a criminal law that applies broadly and prohibits the knowing and willful payment of remuneration to induce or reward patient referrals or the generation of business involving any item or service payable by the Federal health care programs.
Highlight of the laws for stark and anti-kickback are
Stark
1.Civil penalties
2.Applies only to Designated Health Services (DHS) paid for by Medicare
3.Is strict liability (no intent required)
4.Must involve a physician and an entity

The Anti- Kickback Statute
1.Civil and criminal penalties
2.Applies to Medicare and any Federal Healthcare Program
3.Requires proof of improper intent
4.Applies to any referral source (not just physicians)

Under the Anti-Kickback Statute, a company commits fraud when it offers doctors and other health care providers financial incentives to use the business’s products or services, for which payment may be made under Medicare, Medicaid or other federally-funded healthcare programs. The illegal kickbacks can be cash payments, but often include other items of monetary value, such as gifts, free or discounted supplies or services, and travel.
Another law, called the Stark Statute, regulates the financial relationship that a physician or other provider can have with companies that sell healthcare items or services. When doctors or other healthcare providers benefit financially from referring patients to a particular hospital or testing center, they are incentivized to send patients for medically unnecessary, sometimes dangerous treatments. It tries to prevent subjecting patients to unnecessary procedures, making it illegal for physicians to refer Medicaid or Medicare patients to any entity with which it has a financial relationship, such as ownership, investment interest or compensation arrangements.

The False Claims Act offers whistleblowers an effective way to expose and stop kickbacks in the healthcare system. Kickbacks – hidden financial arrangements between doctors and hospitals or other healthcare providers or companies – are one of the most complicated and troubling aspects of the healthcare system.

Kickbacks to doctors or other healthcare providers are prohibited by two federal laws: the Anti-Kickback Statute and the Stark Statute. Whistleblowers can work with the government to stop kickbacks and receive a reward by filing a "qui tam" lawsuit under the False Claims Act.

Following is the link to some of the contexts in respective acts:

https://www.healthlawyers.org/Events/Programs/Materials/Documents/FHL14/scielzo_slides.pdf

The Civil Monetary Penalties Law authorizes the imposition of substantial civil money penalties against an entity that engages in activities including, but not limited to:
1) Knowingly presenting or causing to be presented, a claim for services not provided as claimed or which is otherwise false or fraudulent in any way.
2) Knowingly giving or causing to be given false or misleading information reasonably expected to influence the decision to discharge a patient.
3) Offering or giving remuneration to any beneficiary of a federal health care program likely to influence the receipt of reimbursable items or services.
4) Arranging for reimbursable services with an entity which is excluded from participation from a federal health care program.
5) Knowingly or willfully soliciting or receiving remuneration for a referral of a federal health care program beneficiary, or
6) Using a payment intended for a federal health care program beneficiary for another use.
https://www.healthlawyers.org/hlresources/Health%20Law%20Wiki/Civil%20Monetary%20Penalties%20Law.aspx

The link that hmp42 posted is very interesting and worth the quick read. I think it's great to know what the acts mean and why they are important, but I think the real world examples of how they were violated further solidify the importance.
In the article hmp42 posted, Health Alliance of Greater Cincinnati and The Christ Hospital in Ohio, were required to pay over $100 million dollars due to anti-kickback violations. They were paying doctors to refer patients to their facilities. In the moment that may not seem like such a big deal, but once this information was found, it is just simply corrupt, and they were forced to pay a HUGE fine. $100 million dollars is a massive fine, simply because you were trying to recruit patients the wrong way. Paying doctors to refer patients isn't in the patients' best interests 100% of the time. For example, maybe this facility isn't equipped enough to deal with some conditions, or other hospitals have a more experienced staff. Now, patients who may need different care are now coming to a facility that potentially could have what they need. If this isn't enough to make your company not incentivize doctors, then simply just look at the fine. What these hospitals thought was no big deal ended up costing them over $100 million dollars in fines. Fines like this not only drain your bank accounts, but also leave the public with a sour image of your hospital.

-Kaitlin Connell

Stark law, is a complex set of regulations that has constantly expanded since its initial publication in 1995. Stark law restricts the physician from self referral patient to a designated place where he or his family members has a financial relationship unless an exception is met. It tends to eliminate any financial benefit to physicians through referring any patient to designated labs or hospitals for unnecessary tests or treatment. Physicians should receives fair market Patrice for their services.The Anti-kickback statute prohibits to receives any gift in exchange for rewarding referral for federal healthcare programs. The need to decide the fair market value of payments so as to defend that they are not in exchange for referrals has led to an explosion in the need for valuation services.

CMPL stands for Civil Monetary Penalties Law. In general CMPL are as result of mistakes made wither directly or indirectly against the law. As a consequence monetary compensation is required to be free of the act committed and/or partially makes one free of the debt they legally owe. Itis set by law makers how much a given act done wrongly costs. This is what I understand it to be. One example of something done wrong.
(a) Improperly filed claims
- If the claims certain devices ,drugs etc are not doing what the inventors, investigators etc say it will then they will be penalized by a monetary penalty.

Stark law restricts the physician from referring patient to a designated place where he or his family members has a financial relationship unless an exception is met. It is intended to eliminate financial motivation for a physicians to refer a patient to a lab or hospitals for unnecessary tests or treatment in order just to get money.The Anti-kickback statute prohibits physician from receiving any gift for referral of patient for federal healthcare programs. The need to decide the fair market value of payments has led to an explosion in the need for valuation services. Overall these laws are meant to protect the patient, hopefully not at an unfair cost to the physician.

False Claims Act violations can result in the following:
• Damages penalty triples the amount of money defrauded from the government
• Claim penalties from $11,000 - $22,000 for each claim that violates the False Claims Act
Anti-kickback Status (AKS) violations can result in the following:
• Criminal penalties include fines up to $25,000 and 5 years imprisonment
• Civil penalties include up to $50,000 per violation plus 3 times the amount of government overpayment
Stark law violations can result in the following:
• Civil penalties up to $15,000 per service in violation of the law
• Penalties up to $100,000 for circumvention schemes (physician arrangements having purpose for ensuring referrals to an entity in violation to the law
• Physician excluded from participating in Medicare and Medicaid programs
Civil Monetary Penalties Law (CMPL) violations can result in the following:
• Equal to the gains made from the activity of violating the law