Wednesday, 08 May 2013 21:24

Gift Giving and the Anti Kickback Law

Even though the Holiday season is long gone Healthcare Providers need to pay attention to the value of gifts they give or receive to avoid violating the Anti Kickback Laws. Providers may not accept any one gift with a value of more than approximately $30.00 or gifts worth more than $350.00 annually. The Government is concerned that gifts may cause billing for unnecessary services or may affect the referral of patients. Providers as well as their employees must not solicit gifts

either. When a gift is given or received it must not be based upon either the volume or value of any referrals. Gifts that are given frequently after referrals or after any specific successful referral are red flags for violations of the law. In fact the Sunshine Act now requires pharmaceutical companies and durable medical equipment companies to report gifts to providers with a value over $25.00.

The fact that CMS may not currently be investigating or bringing enforcement proceedings for violations of the rules related to gift giving should not be interpreted that any one gift will not cause a problem in the future. Providers must not let their guard down. Do not make the mistake and think it is O.K. to go on a fishing charter or accept a gift certificate just this one time. Even though the one event may seem inconsequential when combined with other factors it can end up causing you much greater expense and stress than the value of the gift.

It is always best to be in compliance with the law. Violation of the law can lead to enforcement proceedings and penalties which can have severe consequences.

The law provides for a reward and protection of the “Whistleblower”. It is not simply the Government enforcing the law. Employees and Ex Employees are incentivized by the law to report violations no matter how minor by the reward they will receive for reporting a violation of the law. Most recently the Government commenced a False Claims Act lawsuit against alleging payment for dining and fees for presentations were actually disguised kickbacks