Kickbacks can be one of the hardest skilled nursing compliance risk areas for employees to recognize—especially for employees who are new to health care. Kickbacks also bring some of the largest OIG compliance penalties for providers.
The largest long term care pharmacy company in the country agreed to a $124.24 million settlement with the government after it allegedly offered inappropriate financial incentives to SNFs in exchange for their continued use of the pharmacy.
The pharmacy was accused of entering below-cost pharmaceutical contracts with SNFs—in order to induce the SNFs to contract with that pharmacy.
The Department of Justice press release explains: “The Anti-Kickback Statute prohibits offering, paying, soliciting or receiving remuneration to induce referrals of items or services covered by Medicare, Medicaid, and other federally funded programs.”
The Department also stated: “Nursing homes should select their pharmacy provider based on the best quality, service and cost to the residents, not based on improper discounts to the nursing facility.”
Compliance officers likely recognize that this type of arrangement involves prohibited kickbacks. But, does the compliance officer enter all of the SNF contracts? Probably not. Do the administrator and department heads, and any other parties who sign on the dotted line, know how to recognize kickbacks? Do they know when discounts are dangerous? This is especially important for employees who come from non-healthcare industries, where a discount is less likely to violate the law.
Remember, it doesn’t take an evil mindset to violate the Anti-Kickback Statute. OIG compliance programs in nursing homes should devote ample resources to helping employees avoid inadvertent non-compliance. MPA recommends helping your employees recognize non-compliance by using regular, ongoing compliance training and reminders.