The Big Three: Fraud and Abuse Law, Anti-Kick Back Statue & Stark Law

Description

Healthcare organizations face increasing regulatory pressure, making a clear understanding of fraud and abuse laws more important than ever. This webinar explores the “Big Three” that form the foundation of healthcare compliance: the Federal Fraud and Abuse Law framework, the Anti-Kickback Statute (AKS), and the Stark Law. Together, these laws govern financial relationships, referral practices, and billing behaviors across the healthcare industry.

This session will break down legal concepts into practical, easy-to-understand insights. Participants will learn how the Anti-Kickback Statute addresses improper financial incentives tied to referrals, and how Stark Law strictly regulates physician self-referrals for designated health services. The webinar will also highlight how these laws intersect, where they differ, and why even unintentional violations can result in significant penalties.

Through real-world examples and common risk scenarios, attendees will gain a deeper understanding of how these regulations apply to everyday operations, including contracting, compensation arrangements, and referral patterns. Whether you are part of a compliance team, legal department, or operational leadership, this webinar will provide the knowledge needed to recognize potential risks and support a culture of compliance within your organization.

Webinar Objectives

Understanding Key Federal Fraud & Abuse Laws

• Core principles behind federal fraud and abuse regulations
• Common violations that impact billing operations
• How enforcement agencies identify improper billing practices

Stark Law (Physician Self-Referral) Essentials

• What constitutes a prohibited referral
• Financial relationship rules and applicable exceptions
• How Stark Law violations affect billing, claims, and reimbursement

Anti-Kickback Statute (AKS) Fundamentals

• Definition of “remuneration” under AKS
• Safe harbors and their application in billing-related arrangements
• Impact of AKS enforcement on billing companies and their clients

High-Risk Areas in Medical Billing

• Key red flags leading to legal and financial liability
• Identifying improper documentation and coding patterns
• Recognizing risky referral relationships

Compliance Responsibilities of Billing Companies

• Role in preventing, detecting, and reporting violations
• Best practices: internal audits, oversight controls, and staff training
• Protecting organization and provider clients from enforcement actions

Webinar Highlights

• Overview of the Federal Fraud and Abuse Law framework and enforcement landscape 
• Breakdown of the Anti-Kickback Statute: intent, scope, and real-world implications 
• Understanding Stark Law: physician self-referrals and strict liability risks 
• Key differences and overlaps between AKS and Stark Law 
• Common compliance pitfalls and enforcement trends 
• Practical strategies to reduce risk and strengthen compliance programs

Who Should Attend?

• Medical billing and coding professionals
• Revenue cycle managers and directors
• Practice administrators and office managers
• Compliance officers and internal auditors
• Front-desk and patient access staff
• Healthcare providers seeking insight into billing and compliance risks
• Anyone involved in claim submission, follow-up, or denial management