- May 4, 2023
- Events
Labs & Substance Abuse Providers: EKRA Enforcement Update
Garfunkel Wild’s Robert Del Giorno and John G. Martin will present the live webinar “Labs & Substance Abuse Providers: EKRA Enforcement Update” on May 4, 2023 from 12:00 PM - 1:00 PM ET.
Please join us for the fourth session in Garfunkel Wild’s monthly health care compliance webinar series focusing on health care compliance issues impacting your organization.
EKRA was enacted in 2018 in response to the growing opioid crisis, and it was intended to address kickbacks related to the substance abuse treatment industry (e.g., brokering patients and related illegal laboratory testing arrangements). As the healthcare industry knows, however, EKRA goes far beyond the opioid crisis and applies to any remuneration for the referral of a patient to a recovery home, clinical treatment facility, or laboratory. Critically, EKRA also represented a departure from the Antikickback Statute in two material ways: (i) it is an all payor statute (its application is not limited to Medicare, Medicaid and other federal healthcare programs); and (ii) it expressly prohibits paying an employee or contractor based on the number of individuals referred, the number of tests or procedures performed, or the amount billed to or received from a payor for services provided by a recovery home, clinical treatment facility, or laboratory.
After its enactment, EKRA enforcement actions were rare and as a result case law interpreting EKRA has been limited and often conflicting. Over the past year, EKRA enforcement actions have been on the rise and EKRA has been applied outside the substance abuse industry (e.g., COVID-19 testing). Given the government’s increasing enforcement of EKRA, now is a good time for providers to understand the enforcement landscape, understand EKRA’s application and to reassess potentially noncompliant compensation structures.
Please join us for the fourth session in Garfunkel Wild’s monthly health care compliance webinar series focusing on health care compliance issues impacting your organization.
EKRA was enacted in 2018 in response to the growing opioid crisis, and it was intended to address kickbacks related to the substance abuse treatment industry (e.g., brokering patients and related illegal laboratory testing arrangements). As the healthcare industry knows, however, EKRA goes far beyond the opioid crisis and applies to any remuneration for the referral of a patient to a recovery home, clinical treatment facility, or laboratory. Critically, EKRA also represented a departure from the Antikickback Statute in two material ways: (i) it is an all payor statute (its application is not limited to Medicare, Medicaid and other federal healthcare programs); and (ii) it expressly prohibits paying an employee or contractor based on the number of individuals referred, the number of tests or procedures performed, or the amount billed to or received from a payor for services provided by a recovery home, clinical treatment facility, or laboratory.
After its enactment, EKRA enforcement actions were rare and as a result case law interpreting EKRA has been limited and often conflicting. Over the past year, EKRA enforcement actions have been on the rise and EKRA has been applied outside the substance abuse industry (e.g., COVID-19 testing). Given the government’s increasing enforcement of EKRA, now is a good time for providers to understand the enforcement landscape, understand EKRA’s application and to reassess potentially noncompliant compensation structures.