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Potential Criminal Liability Under the AKS
Dr. Kamal Patel, a Chicago-area physician who commonly prescribed home health care services for his patients, was recently convicted following a bench trial of violating the Anti-Kickback Statute (AKS), 42 U.S.C. ' 1320a-7b, and also for conspiring with a home health care provider to break that same law. Dr. Patel was sentenced to eight months in prison and 200 hours of community service, and he was also ordered to forfeit $31,900 in payments that he received from the provider. He appealed, but in United States v. Patel, No. 14-cv-2607 (7th Cir. Feb. 10, 2015), the Seventh Circuit affirmed his criminal convictions, holding that merely “authorizing” medically necessary services can constitute illegally “referring” patients under the AKS, if improper payments are made to the authorizing doctor.
Put simply, the AKS prohibits, among other things, paying or getting paid for “referring” patients for health care services that are paid for, in whole or part, by any federal program, such as Medicare or Medicaid. The relevant part of the statute reads:
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