tci Medicare Compliance & Reimbursement - 2016 Issue 15

Compliance: Don't Trip Over Financial Incentives and Relationships

Note: Kickbacks could be more damaging than self-referrals. Enhanced data analytics allowed the HHS Office of Inspector Generalto zero in on fraudsters and other healthcare wrongdoers in a recent crackdown. Lesson learned: If you don’t know the difference between a kickback and a self-referral you could find yourself on the OIG’s radar. Kickback Refresher With the possibility of both criminal and civil retribution, kickbacks are more detrimental to the offender than referral fraud. Kickbacks refer to any acceptance of reward, incentive, or payment for a referral from anyone, or in technical terms, “patient referrals or the...

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