Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:Introduction to Health Care and Public Health in the U.S.
Unit:Regulating Health Care
Lecture:Legal Aspects of Medicine
Slide content:Federal Fraud and Abuse Laws False Claims Act Anti-Kickback Statute Stark Law Exclusion Statute Civil Monetary Penalties Law 23
Slide notes:Five major federal laws address Medicare and Medicaid fraud, waste, and abuse. Briefly, the False Claims Act prohibits the submission of false or fraudulent claims to the federal government. The Anti-Kickback Statute forbids asking for or receiving anything of value in exchange for referrals of federal health care program business. The Stark Law prohibits physicians from referring Medicare or Medicaid patients to clinical laboratories and certain other services in which they have a financial interest. The Exclusion Statute bans individuals or organizations convicted of certain crimes from being providers in the Medicare and Medicaid programs. The Civil Monetary Penalties Law authorizes the OIG to impose fines on health care providers who commit fraud, waste, or abuse. 23