Rules of the Road: Navigating the Regulations of Cardiac Imaging-Rules of the Road: Navigating the regulations of Cardiac Imaging (slides)

Rules of the Road: Navigating the regulations of Cardiac Imaging (slides)

Pdf Summary

The document discusses the rules and regulations of cardiac imaging from a legal perspective. It focuses on the Federal Anti-Kickback Statute (AKS), False Claims Act (FCA), and the Federal Stark Law. The AKS is a criminal statute that prohibits offering or receiving remuneration for referrals or ordering federally reimbursable items or services. Remuneration includes anything of value and can lead to liability for both payors and recipients. The FCA imposes liability for presenting false claims and requires no proof of specific intent to defraud. The AKS and FCA work together, as a claim tainted by a kickback violation is considered a false claim. FCA claims can be brought directly by the government or by private individuals in a qui tam action. The penalties for FCA violations can include fines and civil sanctions. The Federal Stark Law prohibits physicians from referring patients to entities in which they have a financial relationship unless an exception is met. Stark Law violations can lead to penalties such as civil monetary fines and exclusion from Medicare and Medicaid programs. The document also mentions various exceptions to the Stark Law, such as in-office ancillary services and personal services agreements. Failure to meet the requirements of these exceptions can result in Stark Law violations. The document concludes by providing contact details for further questions.

Keywords

cardiac imaging

legal perspective

Federal Anti-Kickback Statute

False Claims Act

Federal Stark Law

remuneration

payors

recipients

qui tam action

civil sanctions