Violations of either Stark Law or the Anti-Kickback Statute are usually grounds for filing a claim under the False Claims Act. Whistleblowers who know of instances where a physician has made referrals based on having a financial interest in the entity which is receiving the referral or know of instances where a doctor received or gave an incentive in order to obtain business – may have a valid qui tam claim. Whistleblowers who file claims under the False Claims Ac may be entitled to a percentage of any recovery.
Stark Law and the Anti-Kickback Statute (AKS) have similar but not identical aims. They both:
- Aim to ensure patient referrals for services, products, or treatments are based on what is in the best interests of the patient’s health – and not any financial reward
- Aim to protect the integrity of the healthcare system
- Aim to protect taxpayers who help to fund Medicare and/or other federal healthcare agencies
- Aim to protect other medical practices who compete fairly
Some of the differences between the two laws are:
- Stark Law only has civil remedies. The AKS has civil and criminal penalties.
- Stark Law only applies to payments by Medicare and referrals where the physician has a financial interest in a designated health service (DHS). The AKS is broader and applies to any federal healthcare program – not just Medicare
- Stark Law doesn’t require a showing of intent. It’s a strict liability law. The AKS does require proof the wrongdoer intended its misconduct
- Stark Law requires a rereferral between the doctor and the DHS. The AKS applies to more than just doctors. It applies to any health service of any health company.
Stark Law also applies when an immediate family member of the physician is involved.
At the California Law Offices of Stephen Danz and Associates, our qui tam lawyers have the experience and resources to help you pursue your whistleblower case for healthcare fraud or any type of fraud. To review if you have a claim, call us at online contact form to make an appointment.or use our