1. Why is the government concerned with the payment of kickbacks to induce referrals?

Kickbacks increase costs to federal programs.

Kickbacks steer patients to the provider willing to pay the most, rather than to the most qualified or most appropriate provider.

Kickbacks lead to over-utilization of finite healthcare resources.

Kickbacks may corrupt the medical decision-making process.

Kickbacks tend to be unreported income that escapes taxation by the IRS.

2. An Anti-Kickback Statute violation is also a False Claims Act violation.

True

False

3. An Anti-Kickback Statute violation cannot be False Claims Act violation because the Anti-Kickback Statute is a criminal statute, and the False Claims Act is a civil statute.

True

False

4. A provider who pays a kickback for a referral of a Medicare patient violates the Medicare Conditions of Participating upon submission of a claim for reimbursement.

True

False

5. False Claims Act prosecutions are easier because, as a civil cause of action, the burden of proof standard is lower.

True

False

6. Not collecting a Medicare patient's copay may be an illegal kickback.

True

False

7. For purposes of the Anti-Kickback Statute, not collecting a $20 copay is the same as giving the patient $20.

True

False

8. Under the One Purpose Test as articulated in United States v. Greber, if one purpose of a payment to a physician is legal, then it cannot be considered an illegal kickback.

True

False

9. Since the Anti-Kickback Statute applies only to federal program beneficiaries, the Office of Inspector General (OIG) cannot impose liability for payments designated for referral for patients with private insurance.

True

False

10. In the opinion of the Office of Inspector General (OIG), it is acceptable for a referral source to refer both private insurance and Medicare patients to a provider, as long as the provider pays a referral fee only for the private insurance patients. Paying kickbacks for referrals of Medicare patients would violate the Anti-Kickback Statute.

True

False