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Federal Anti-Kickback Law - Prohibits the knowing and willful solicitation, offer, payment, or receipt of any remuneration (broadly interpreted to encompass anything of value), whether direct or indirect, in cash or in like kind, to induce or in return for referring an individual, or purchasing or arranging for an item of service for which payment may be mad under the Medicare, Medicaid, or other government health program. Safe Harbor Provisions - Describes various payment and business practices that, although they potentially implicate the Federal Anti-Kickback Statute, are not treated as offenses under the statute. The Safe Harbor provisions are updated by the OIG and maintained on their website. False Claims - A false Claim includes a claim that does not conform to Medicare's (or other programs) requirements for reimbursement. The Civil False Claim Acts - Imposes civil monetary penalties of between $5,500 and $11,000 plus three times the value of each claim. It prohibits the knowing submission of a false or fraudulent claim for payment to the United States, the knowing use of a false record or statement to obtain payment on a false or fraudulent claim, or a conspiracy to defraud the United States by having a false or fraudulent claim allowed or paid The Criminal False Claim Act: - Prohibits knowingly and willfully making or causing to be made any false statement or representation of material fact in any claims or application for benefits under federally funded health plans as well as commercial carriers. Violations are felonies and are punishable by up to five years imprisonment and/or $25,000 in fines. The Civil Monetary Penalties Law: - Provides for the imposition of civil monetary penalties up to $10,000 per false service claimed, plus assessments equal to three times the amount claimed, for services that the provider knows or should know were not provided as claimed or for claims the provider knows or should know are false or fraudulent. Other federal criminal laws: - Also may be used to prosecute the submission of false claims, including prohibitions on making false statements to the government and engaging in mail fraud. Felony convictions will result in exclusion from Medicare for a minimum of a five-year period. Option for Providers - Self Disclosure: Fines may be less if a practice self-disclosed its knowledge of the violation. Appeal Rights: A practice has the right to an appeal process, and may choose to request a hearing before an administration law judge (ALJ). The OIG and the respondent have the right to present evidence and make arguments to the ALJ, who issues a written decision. Additional Appeal: The ALJ's decision may be appealed administratively and to federal court.