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AAA-PRACTICE COMPLIANCE COMMITTEE PRESENTS:

AAA-PRACTICE COMPLIANCE COMMITTEE PRESENTS:. ANTIKICKBACK STATUTE & STARK LAWS AS THEY APPLY TO AUDIOLOGY PRACTICES. DISCLAIMER.

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AAA-PRACTICE COMPLIANCE COMMITTEE PRESENTS:

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  1. AAA-PRACTICE COMPLIANCE COMMITTEEPRESENTS: ANTIKICKBACK STATUTE & STARK LAWS AS THEY APPLY TO AUDIOLOGY PRACTICES

  2. DISCLAIMER This guidance is provided, without charge, as a service to the profession of audiology and is intended to be adapted and updated by users. This guidance is also  provided with the understanding that the American Academy of Audiology (AAA) is not engaged in rendering legal or other professional services. AAA members are encouraged to seek legal counsel to ensure the accuracy of this presentation. Members are responsible for their own knowledge of both federal and state law and policies. Neither the Academy, nor any of its officers, directors, agents, employees, committee members or other representatives shall have any liability for any claim, whether founded or unfounded, of any kind whatsoever, including, but not limited to, any claim for costs and legal fees, arising from the use of this presentation or any material included herein.

  3. What is the Anti-Kickback statute? • A FEDERAL REGULATION • INVOLVES VIOLATION OF MEDICARE OR STATE HEALTH CARE PROGRAMS • SAFE HARBORS EXIST • CRIMINAL PENALTIES

  4. Who does this statute affect in our profession? • Audiologists who are providers of Medicare • State health care programs may be impacted by analogous state law AKS • Issues related: i.e manufacturers financial relationships with audiologists that are Medicare providers

  5. How is AKS enforced? • Criminal penalties • Potential imprisonment • Financial Penalties

  6. Where can audiologists find information on AKS? • Office of Inspector General website at: http://oig.hhs.gov/compliance/safe-harbor-regulations/index.asp • AAA compliance web site at: http://www.audiology.org/practice/compliance/Pages/Fraud_AbuseGuidance.aspx • General OIG Compliance guidance: http://oig.hhs.gov/compliance/101/index.asp

  7. What is the Stark Law? • Federal Law • Prohibits physician financial investment or related financial interest with an entity that he is referring patients to who are covered by Medicare, Medicaid and third party payer • Exceptions must be reviewed carefully

  8. Who does this law affect in our profession? • Audiologists that receive Medicare, Medicaid and third party payer referrals and/or are family members of physicians • Stark has limited applicability for audiologists

  9. How are Stark Laws enforced? • Criminal Penalties • Imprisonment • Fines

  10. Where can audiologists find information on Stark Laws? • http://www.audiology.org/practice/reimbursement/medicare/Documents/CMS_stark.pdf • http://www.audiology.org/development/eaudiology/ethicsgreenbook/Documents/gb_module1.pdf

  11. Where can audiologists find information on Stark Laws? http://www.audiology.org/Documents/AN2009Handouts/LM505_Coverstone.pdf http://www.audiology.org/practice/compliance/Pages/Fraud_AbuseGuidance.aspx

  12. OIG: Guidance on Healthcare Fraud Compliance • Fraud compliance guidance constantly changing, evolving • Example: over 10 yrs after law enacted, STARK has Parts I, II, and III, each with distinct regulations and agency guidance • Consult HHS Office of Inspector General Website for Guidance at http://oig.hhs.gov/ • See compliance Roadmap at: http://oig.hhs.gov/compliance/physician-education/01laws.asp

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