United States

Healthcare Regulatory Compliance - Physician Contracting

Mar 11, 2015
From the Healthcare & Life Sciences Institute


The Stark Law and Anti-Kickback Statute prohibit physicians from making referrals of certain designated health services that are paid for by Medicaid and Medicare to entities in which the physician (or family member) has a financial relationship. It also prohibits offering, paying, soliciting, or receiving anything of value or rewards for referrals. The risk of violating Stark and Anti-Kickback rules is rising, and the penalties have never been harsher. Not surprisingly, today’s healthcare providers are keenly focused on reviewing and monitoring their business and physician relationships.

At KPMG LLP (KPMG), we understand the complexity of these rules and have deep experience managing the combination of both contracting review and forensic accounting procedures that need to be undertaken to evaluate the physician reimbursement program efficacy. We also know how to manage and balance the often competing interests that arise between business drivers and compliance.

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