The anti-kickback statute standard(s) of intent: the case for a rule of reason analysis.
Mr. Aspinwall presents a comprehensive overview of the anti-kickback statute to show how Congress enacted the legislation to prevent inappropriate utilization and to reduce the ambiguity of the anti-kickback prohibitions by adding a knowing and willful requirement to the standard of intent. He discusses the different lines of caselaw on the anti-kickback standard of intent, and closely examines the standard endorsed by the OIG. He proposes adopting a standard of reasonableness modeled after the rule of reason from antitrust law, using cost-effectiveness as the primary criterion. He argues that a cost-benefit outcomes-based approach to the anti-kickback statute would better serve the public interest.
Aspinwall
T J
TJ
Sacramento office of Nossaman, Guthner, Knox & Elliott, USA.
D016363:Antitrust Laws; D003362:Cost-Benefit Analysis; D019468:Disease Management; D005607:Fraud / Q000331:legislation & jurisprudence* / Q000517:prevention & control; D006300:Health Services Misuse; D006801:Humans; D018584:Physician Self-Referral / Q000331:legislation & jurisprudence; D012017:Referral and Consultation / Q000331:legislation & jurisprudence*; D014481:United States; D014483:United States Dept. of Health and Human Services