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Denver Stark Law &  Anti-Kickback Attorney

Sequoia Legal offers you the services of attorneys who concentrate on the Stark Law and the Anti-Kickback Statute. We can review proposed transactions in advance, and we can advise you on the legal risks involved. We serve clients throughout the Denver metropolitan area.

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The healthcare industry is highly regulated. The Stark Law, for example, prevents a physician from referring certain patients to a healthcare provider with whom the physician has a financial relationship.

The Anti-Kickback Statute (“AKS”), by contrast, prohibits the referral of Medicare services for any form of compensation whatsoever.

These laws can come into play in transactions that might surprise you, including:

  • Employment contracts
  • Leases
  • Compensation structures
  • Sale of a practice
  • Complementary goods or services

What Is The Stark Law (a.k.a. the Physician Self-Referral Law)?

Unlike the Anti-Kickback Statute, the Stark Law, also known as the Physician Self-Referral Law, forbids physicians from referring patients to Designated Health Services (DHS) providers if there is a financial relationship between the physician (or their immediate family) and the DHS provider. Stark Law restrictions apply to physicians only.

The Stark Law is a civil law, with civil penalties, as opposed to a criminal statute.

What Is The Anti-Kickback Statute (AKS)?

The Anti-Kickback Statute (AKS) is a statute far broader in its coverage than the Stark Law. It applies to any healthcare provider, not only physicians. It forbids both the payment and receipt of compensation in exchange for referrals. Penalties for violation include both civil and criminal penalties.
“Referrals” means referrals for medical services as well as any goods or services that Medicare or Medicaid could reimburse. This includes the purchasing or leasing of medical equipment or facilities.

There are numerous “Safe harbor” provisions including but not limited to:

  • Bonafide employees;
  • Personal services and management contracts; and
  • Discounts for healthcare providers (subject to conditions).

Why You Need A Healthcare Attorney Specializing In Stark Law and AKS

You need a Stark Law attorney to help you with compliance because:

  • There are many exceptions to Stark Law and AKS that need to be analyzed in order to determine whether your business structure is compliant.
  • You can break the Stark Law without even knowing it because your intent is irrelevant. Consequences could include tens of thousands of dollars in fines for each violation.
  • You could face both civil and criminal penalties for AKS violations.
  • Violations of AKS and Stark Law often involve violations of other federal statutes, including the False Claims Act, which increases penalties.

You need an expert attorney to structure all of your transactions and contracts carefully and compliantly.

We Represent Healthcare Professionals Covered by the Stark Law and AKS

The Stark Law and the AKS combined apply to a wide variety of different types of healthcare professionals and organizations. We have represented a variety of clients  at some point or another, including:

  • Doctors
  • Ambulance services
  • Federally Qualified Health Centers (FQHC)
  • Healthcare consultants
  • Healthcare professionals
  • Nursing homes and assisted living facilities
  • Other healthcare organizations

Services We Provide For Your Healthcare Entity Regulatory Compliance

Our healthcare industry attorneys can help keep you in compliance with the Stark Law, Anti-Kickback Statute, and other healthcare industry regulations. In addition, we can help you structure your business transactions, create policies and procedures, and educate both your workforce and third-party professionals on compliance issues.

The following is an abbreviated list of some of the compliance services we offer:

  • Appropriately address any overpayments
  • Assisting you with corrective action
  • Conducting internal audits to determine whether your organization has violated any regulatory standards
  • Create compliant compensation arrangements
  • Designing new compliance procedures
  • Drafting agreements and other legal documents
  • Drafting compliance policies to avoid infractions and audits
  • Establishing new entities or joint ventures
  • Evaluating your transactional practices to ensure that they comply with applicable law
  • Handling mergers and acquisitions
  • Holding seminars to educate your employees on compliance requirements
  • Seeking advisory opinions from the Office of Inspector General
  • Structuring your transactions to ensure compliance
  • Adjusting policies and procedures to address evolving regulatory standards
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Why Retain Sequoia Legal Attorneys For Stark And Anti-Kickback Compliance?

The Stark Law and the AKS combined apply to a wide variety of different types of healthcare professionals and organizations. We have represented a variety of clients  at some point or another, including:

  • We enjoy extensive experience in every aspect of healthcare regulations
  • We are small enough to offer personalized service but big enough to command the resources that sole practitioners lack
  • We have a stellar track record of helping other clients with healthcare regulatory compliance issues

Meet Our Experienced Stark Law Attorneys

Andrew LopezAndrew Lopez
Hunter BooneHunter Boone
Christina MurrayChristina Murray
Josh WallensteinJosh Wallenstein
Laura A. LopezLaura A. Lopez
Brian FonvilleBrian Fonville

FAQs

What is the difference between the Stark Law and the Anti-Kickback Statute?

The differences between the Stark Law and the Anti-Kickback Law include:

  • You can violate the Stark Law unintentionally
  • You can go to jail for violating the Anti-Kickback Law
  • The standard of proof for the Anti-Kickback law is higher than the standard of proof for the Stark Law
  • The Stark Law applies only to physicians, while the Anti-Kickback Law applies to anyone receiving Medicare or Medicaid

What Are the Designated Health Services The Stark Covers?

List of Designated Health Services (DHS):

  • Clinical lab services
  • Home health services
  • Hospital services
  • Medical equipment
  • Occupational therapy
  • Outpatient prescription drugs
  • Outpatient speech-language and pathology services
  • Parenteral and enteral nutrients, equipment, and supplies
  • Physical therapy
  • Prosthetics, orthotics, and related equipment and supplies
  • Radiation therapy
  • Radiology

What Are The Penalties For Stark Law Violations?

The penalties for violatIons of the Stark law can include:

  • Refusal to pay for services
  • Refund of payments already collected
  • Fine of 3x the amount improperly received under Medicare
  • Exclusion from Medicare, Medicaid, and state programs 
  • A penalty of up to $15,000 per violation
  • A penalty of up to $100,000

What Are The Exceptions To The Stark Law and Safe Harbors To The Anti-Kickback?

Taking advantage of an exception or a “safe harbor” helps you avoid violating the law. Exceptions and safe harbors include:

  • In-office ancillary services
  • Intra-group referrals
  • Lease agreements
  • Personal service agreements
  • Referrals within prepaid health plans

Many other exceptions and safe harbors exist as well.

What Other Healthcare Regulations Do You Provide Counsel For?

he Stark Law and the Anti-Kickback Statute are not the only laws regulating healthcare. We advise our clients on a multitude of laws, including:

  • The False Claims Act
  • The Physician Payment Sunshine Act

We also advise on fee-splitting laws, licensing requirements, reimbursement requirements, and other self-referral laws, of which there are many. 

Protect Your Business Today With Qualified Healthcare Compliance Counsel

The consequences of running afoul of healthcare kickback and self-referral laws are far too serious for you to be taking any chances with your business, your finances, your professional reputation, and your freedom. You can rely on our expertise to keep you out of trouble.

Discuss Your Matters With Our Experienced Denver Export Compliance Lawyers

Federal export regulations are so complex that you need a certain amount of knowledge even to determine whether or not you have a problem. We can advise you, help you navigate the export control minefield before a violation occurs, represent you before government agencies, and advocate on your behalf. Contact the export control law firm Sequoia Legal today at (303) 476-2851 or contact us online to schedule a consultation.

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7355 E. Orchard Rd., Suite 375 Greenwood Village, CO 80111

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We contacted Sequoia Law after an internal audit revealed that our company had inadvertently committed two substantial OFAC violations over the past two years. We chose the path of voluntary disclosure to OFAC and received lenient penalties. Many thanks to Sequoia for their adroit handling of the matter.

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Our previous attorney had drafted us NDAs that were so full of holes that it left unscrupulous former employees almost complete freedom to deal with our trade secrets as they wished. Sequoia Legal helped us plug those loopholes and prevent further leakage of valuable trade secrets. I can’t recommend them highly enough.

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We hired Sequoia Legal to help us organize and protect our intellectual property needs. They identified problems we didn’t even know we had, and they helped us head off serious oversights that might have bankrupted our company if we hadn’t caught them in time.

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Sequoia Legal has been helping us with regulatory compliance matters for years now. So far, we have not had a single complaint lodged against us by any patient or entity, and no enforcement actions have been implemented or threatened. I can’t praise them enough.