Ant-Kickback Statute and Physician Self-Referral Law

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Dr. Samuel is an internal medicine physician. This practice does not have lab service. When Dr. Samuel orders lab work, she recommends the patient to Lucky Lab. Lucky Lab is very appreciative that Dr. Samuels patients use their lab. Lucky Lab is so appreciated that for every patient of Dr. Samuel that uses their lab, they give Dr. Samuel two sports tickets of her desire.

The primary objective of any healthcare provider should be a favorable outcome for their patients. To achieve this goal, healthcare workers need to be objective and deliver only quality services. When making a recommendation of a third-party product or service, physicians need to make their decisions based solely on the quality of the commodities they are recommending. Dr. Samuels relationship with Lucky Lab is, above all, an ethical concern. The physician accepts remunerations from the lab, which may pose a hindrance to her objective decision-making. There would be no issue if Dr. Samuel recommended Lucky Lab only because the latter provides exceptional services. However, because the physician is accepting the rewards, it means that her decisions may be affected by prospective monetary and non-monetary benefits.

From the provided information, it is not possible to determine whether or not their services fall under federal healthcare programs. The case is a legal issue if Dr. Samuel and Lucky Lab serve Medicaid and Medicare patients. The lab is violating the Anti-Kickback Statute while the doctor is breaking the Physician Self-Referral Law. The former prohibits health providers from paying rewards to receive more patient referrals for services covered by federal healthcare programs (Office of Inspector General, n.d.). The latter restricts physicians from referring patients to other providers with which the doctor or their family member has a financial relationship (Office of Inspector General, n.d.). These laws do not differentiate between monetary and non-monetary rewards (Office of Inspector General, n.d.). Therefore, sports tickets are considered as remuneration, and both the physician and the lab are violating the law. Dr. Samuel needs to stop receiving any benefits from Lucky Lab and has to ensure that her decisions are objective.

Reference

Office of Inspector General. (n.d.). A roadmap for new physicians: Fraud & abuse laws. Web.

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