As the economy continues to flourish, there is a proliferation of merger and acquisition activity in the healthcare space. We continue to see a rise in ketamine clinic acquisitions as well as investors who are starting management services organizations (“MSO”) to assist such clinics with their administrative burden. Likewise, we have seen an increase in joint venture activity between ketamine clinics and MSOs. For those clinics that receive any kind of federal reimbursement (e.g., Medicare, Medicaid, the VA, etc.), the federal anti-kickback (“AKS”) statute applies – and the AKS has criminal penalties, including jail time.
We have previously written about the AKS and how it applies to ketamine clinics (click here to review). In general, the AKS prohibits anyone from receiving or paying any form of remuneration for the referral patients who are covered by federal reimbursement (and some state laws prohibit the same for private insurance and self-pay patients).
The primary investigative arm for federal reimbursement fraud and abuse activity is the Office of Inspector General (“OIG”) which is housed in the U.S. Department of Health & Human Services. Among other things, the OIG provides guidance to the healthcare industry in a variety of ways, including fraud alerts, opinion