Insights & Resources

Medicare/Medicaid Fraud & Abuse Resource Center

Medicare/Medicaid Fraud & Abuse Resource Center

    The Physician Self-Referral (Stark) Law and Anti-Kickback Statute (often referred to collectively as the fraud and abuse laws) are federal laws that apply to financial relationships that health care providers have with physicians and other referral sources. These laws are intended to protect patients covered by programs such as Medicare and Medicaid from biased medical decision-making and increased costs. From sole practitioners to large health systems, all providers need an understanding of how to comply with the fraud and abuse laws and avoid violations.

    Several attorneys in Bricker’s health care practice focus specifically on fraud and abuse laws. Our team helps providers identify potential problem areas and proactively find solutions that reduce risk. When necessary, we help our clients resolve compliance issues by investigating potential violations, developing corrective action/remediation plans and addressing problems effectively. We also help our clients defend qui tam (whistleblower) lawsuits and government investigations that pertain to the fraud and abuse laws.

    This resource center outlines the statutes, regulations, and other documentation regarding Medicare and Medicaid fraud and abuse and provides a consolidated guide to regulation updates.

    2020 Final Rules: Stark Law and Anti-Kickback Statute Regulations

    On November 20, 2020, the Centers for Medicare and Medicaid Services and the Department of Health and Human Services Office of Inspector General issued final rules to "modernize and clarify the regulations that interpret” the Physician Self-Referral Law (Stark Law) and the federal Anti-Kickback Statute. More

    Proposed Changes to the Stark Law and Anti-Kickback Statute Regulations

    On October 9, 2019, the Centers for Medicare and Medicaid Services and the Department of Health and Human Services Office of Inspector General issued long-awaited proposed changes “to modernize and clarify the regulations that interpret” the Physician Self-Referral Law (Stark Law) and the federal Anti-Kickback Statute. More