Marketing to Medicare or Medicaid Beneficiaries – What You Can and Cannot Do

Description

Because the Anti-Kickback Statute is so broad it what it proscribes, healthcare organizations, conducting what would be normal marketing activities in other industries, have run afoul of the Statute on numerous occasions.  The Statute and the regulations only tell part of the story.  This program will review not only the Statute and its safe harbors but will provide an in-depth overview of OIG guidance and advisory opinions dealing with marketing activities, as well as a review of case law regarding marketing behavior. 

This program will discuss the Federal Anti-Kickback Statute, what it prohibits, its penalties, its scope and its exceptions. It will also discuss how the Medicare and Medicaid Patient and Program Protection Act of 1987 changed the Act and how it is administered. It will also discuss how the 1987 Act added protections for entities covered by the AKS. 

The program will also review guidance from the Department of Health and Human Services Office of the Inspector General as well as case law interpreting the AKS. In addition, we will also provide recommendations regarding how organizations should conduct marketing activities. 

BACKGROUND: 

The Medicare/Medicaid Fraud and Abuse Anti‑Kickback Statute (the “Statute”) is alive, still with us and as viable as ever. The Statute provides that the offer or payment, as well as the solicitation or receipt, of “any remuneration” in exchange for referrals of any good, facility, service, or item for which payment may be made in whole or in part under Medicare/Medicaid is prohibited.

WHY SHOULD YOU ATTEND: 

If your organization, be it a hospital, physician practice, DME provider, or any other provider offering healthcare services or supplies, engages in marketing its product or services, care must be taken to ensure that the organization does not run afoul of the Anti-Kickback Statute.  This program will review not only the Statute itself, and the safe harbors, but will also critique the case law, OIG advisory opinions, and OIG compliance guidance to help you understand what you can and cannot do with engaging in healthcare marketing.

When you finish this program, you should have a good understanding of what you can and cannot do with regard to marketing activities.  The penalties for not conducting a marketing program correctly can be severe, including exclusion, civil monetary penalties and even criminal prosecution.

AREAS COVERED IN THE PRESENTATION:

• A brief review of the Anti-Kickback Statute, what it is and what is prohibited.
• A brief review of the safe harbors that relate to marketing activities.
• A review of the OIG advisory opinions as they relate to marketing.
• A review of OIG compliance guidance as it relates to marketing.
• An overview of case law relating to marketing activities.
• Strategies that should be taken to preclude liability.

TARGET AUDIENCE: 

• Hospital executives
• Physicians, including dentists, podiatrists and chiropractors
• Physician practice executives
• DME provider executives
• Ancillary service providers
• Ancillary service provider executives. And 
• Attorneys representing any and all of the above.