Life Science Compliance Update

January

2017

Co-Payment & Deductible Waivers as Illegal Inducements

Written by , Posted in Abstract, Enforcement

Robert N. Wilkey, Esq., Staff Writer for Life Science Compliance Update

Health insurance providers and out-of-network providers, have found themselves in murky water by providing waivers of co-payments, coinsurance, and deductibles to patients treated by out-of-network laboratories and other providers, where commercial insurers continue to seek legal reimbursement actively, recovery and collection claims against such providers, alleging in pertinent part False Claims Act (“FCA”), Anti-Kickback Statute Violations (“AKS”), and other legal claims. Such efforts are requiring Courts to identify, determine, evaluate, and when waivers of co-payments, coinsurance, and deductibles, constitute such FCA and AKS violations.

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