What is an OIG advisory opinion?
What is an advisory opinion? An Office of Inspector General (OIG) advisory opinion is a legal opinion issued by OIG to one or more requesting parties about the application of the OIG’s fraud and abuse authorities to the party’s existing or proposed business arrangement.
What type of clients does the federal Stark Law prohibit a physician from referring to a health care provider if a financial relationship exists?
Stark prohibits physicians from referring their patients to other entities for designated health services (“DHS”) payable by Medicare when the physician or an immediate family member of the physician has a direct or indirect financial relationship with the entity. These referrals are commonly known as “self-referrals.”
What is a safe harbor under the Anti Kickback Statute?
2] The safe harbor regulations define payment and business practices that will not be considered kickbacks, bribes, or rebates that unlawfully induce payment by Medicare or Medicaid programs. The regulations specify allowable financial and referral relationships between physicians or other providers and suppliers.
What is stark and anti kickback law?
The federal government instituted the Anti-Kickback Statute and Stark Law in an effort to eliminate healthcare fraud and abuse. Simply stated, both regulatory laws prohibit medical providers and/or entities from making health service referrals in exchange for compensation of any kind.
How long are advisory opinions?
How long will it take for you to process my Advisory Opinion request? It will take the Waiver Review Division 4 to 6 weeks to review your request and determine whether the two-year home-country physical presence requirement applies to you.
Why does the ASB issue advisory opinions?
Advisory Opinions are issued by the Appraisal Standards Board (ASB) for the purpose of illustrating the applicability of USPAP in specific situations and offering advice for the resolution of appraisal issues and problems.
What happens if you violate the Stark Law?
What are the penalties for violating Stark? Penalties for violating Stark can be severe. They include denial of payment, refund of payment, imposition of a $15,000 per service civil monetary penalty and imposition of a $100,000 civil monetary penalty for each arrangement considered to be a circumvention scheme.
Does Stark apply to non physicians?
The Stark statute pertains only to physician referrals under Medicare and Medicaid (“physicians” includes chiropractors and dentists but not midlevel providers, such as nurse practitioners and physician assistants); the anti-kickback statute is far broader and affects anyone engaging in business with a federal health …
Is safe harbor voluntary?
SAFE HARBORS GENERALLY Compliance with safe harbors is voluntary, and arrangements that do not comply with a safe harbor must be analyzed on a case-by-case basis for compliance with the anti-kickback statute.
What safe harbor means?
A safe harbor is a legal provision in a statute or regulation that provides protection from a legal liability or other penalty when certain conditions are met.
Is Stark Law criminal?
§ 1320a-7b.) is a criminal statute that prohibits the exchange (or offer to exchange), of anything of value, in an effort to induce (or reward) the referral of business reimbursable by federal health care programs.
Is Stark Law strict liability?
The Stark law is a strict liability statute, which means proof of specific intent to violate the law is not required. The Stark law prohibits the submission, or causing the submission, of claims in violation of the law’s restrictions on referrals.