False Claims Act lawsuits often hinge on arrangements between healthcare providers and others which implicate the federal Anti-Kickback Statute (“AKS”) or Stark Law (or both laws). While the two laws overlap in some respects and both seek to minimize the noxious effects that financial incentives have on medical decision-making, they also differ in many respects.
Most importantly, for purposes of the False Claims Act, the Department of Justice (“DOJ”) has exhibited a longstanding interest in pursuing whistleblower cases which involve violations of the AKS or Stark Law. Consistent with the public policy underpinnings of the AKS and Stark Law, the DOJ recognizes that the financial relationships prohibited by these laws tend to improperly inject financial benefits into decisions impacting patient care. Such arrangements may result in overutilization of healthcare services and products and poor outcomes for patients. Improper inducements and financial relationships can also create a less-than-level playing field among participants in the market. Improper financial arrangements can provide a competitive advantage to those in the healthcare industry.