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Legal Aspects of Health Administration - Essay Example

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The Federal laws that may be applicable in this case are: Section 1877 of the Social Security Act which prohibits a physician from referring Medicare or Medicaid program, patients for certain "designated health services" to an entity with which the physician or an immediate…
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able medical equipment and supplies, parenteral and enteral nutrients, equipment, and supplies, prosthetics, orthotics, and prosthetic devices and supplies, home health services, outpatient prescription drugs, inpatient and outpatient hospital services and nuclear medicine. However the Law has around 35 exceptions that describe acceptable financial relationships that allow a physician to refer to an entity for the provision of designated health services. (Stark Law Questions & Answer). This anti-kickback statute, which states the punishment that may be meted out to anyone who knowingly, and willfully pays any remuneration to induce referrals of federal health care program services and products.

Medicare & Medicaid Patient Protection Act 1987 (42 U.S.C. 1320a-7b) provided for criminal penalties for certain actions of Medicare and state health care .Under it, any offeror who induces another, inter alia, to refer people for providing any services which are been currently paid out of Medicare or state Funds, shall be liable for prosecution, with fine ranging to $25,000 and also five years’ imprisonment. (Manning, 1996). However, there are exceptions for Anti-kickback Laws which are known as safe harbors.

Soon after the decision in the famed Jeffrey Feldstein v. Nash Community Health Services Inc., during November 1999, eight new anti-kickback safe-harbor provisions were published in addition to the existing 15 safe-harbors. The safe harbor provisions include actions such as investments in large publicly held health care companies, small healthcare joint ventures, rentals of space or equipment, personal services agreements, sales of retiring physicians’ practice, discounts and other arrangements, waivers of Medicare Part A inpatient cost-sharing amounts, managed care arrangements involving particular price reductions and enrollee incentives, investments in group practices and ambulatory surgical centers, joint ventures, practitioner recruitment, sales of physician

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