(L-R)Kandis Kovalsky and Edward Kang, with Kang Haggerty. Courtesy photos Fighting Fraud in Health Care Through the False Claims Act in the Third Circuit, Part 2
The statute does not define the term "resulting from," which has led to differing interpretations of the causation standard required for an AKS violation to be considered a false claim under the FCA. The divergence of views among the circuit courts has created challenges for relators in proving causation. This column is part two of our earlier column relating to AKS and the causation standard.
June 15, 2023 at 12:05 PM
9 minute read
The federal health care system depends on the good faith and honesty of its providers. To maintain the system's integrity, those who prioritize incentivized remunerations must be held accountable. Recognizing the need to eliminate the profit motive from decision-making, Congress enacted the Anti-Kickback Statute (AKS). The Anti-Kickback Statute makes it illegal for healthcare providers to offer or accept gifts, bribes, payments, or other financial incentives in exchange for referrals, prescriptions, or other medical services when those services will be paid for partly or wholly by Medicare, Medicaid, or other government-funded health programs.
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