42 U.S.C. § 1320a-7b – Criminal penalties for acts involving federal health care programs (Anti-Kickback Statute and related offenses)
This law makes it a federal crime to offer, pay, solicit, or receive kickbacks or other improper payments involving federal health care programs like Medicare or Medicaid.
Section 1320a-7b covers several different health care fraud offenses. The most well-known part is the Anti-Kickback Statute (AKS), which makes it illegal to exchange anything of value in return for patient referrals or for purchasing items or services paid for by a federal health care program. The law also punishes lying on Medicare/Medicaid applications and billing for services that were not provided.
What the law prohibits.
A person violates this statute if they knowingly and willfully do any of the following:
- Offer or pay kickbacks, bribes, or rewards to encourage referrals of patients or business reimbursed by a federal program.
- Ask for or receive kickbacks or bribes in exchange for making referrals or ordering federally funded services or equipment.
- Submit false statements or misrepresent information in applications or claims for Medicare, Medicaid, or other federal program benefits.
- Bill for services or items that were not provided or were not medically necessary.
- Fail to disclose required information related to ownership, relationships, or payments connected to federal health care programs.
Penalties.
Violations of § 1320a-7b can result in:
- up to 5 years in federal prison,
- criminal fines,
- civil penalties and treble (triple) damages,
- mandatory exclusion from federal health care programs, and
- potential professional licensing consequences.
The Anti-Kickback Statute does not require that the kickback scheme actually succeed — simply offering or requesting something of value is enough to violate the law.
If you are being investigated for kickbacks or other federal health care crimes, call (314) 900-HELP or contact our criminal defense attorneys for guidance.
