Anti-Kickback Statute (AKS): Federal law prohibiting the exchange of anything of value to induce or reward referrals of federal healthcare program business
Stark Law: Federal physician self-referral law prohibiting physicians from referring Medicare/Medicaid patients to entities with which they have a financial relationship
False Claims Act: Federal law imposing liability on persons/companies who defraud governmental programs, including Medicare/Medicaid
HIPAA: Federal law establishing national standards for protection of patients' medical records and other personal health information
IRS Independent Contractor Guidelines: Federal guidelines determining worker classification as independent contractor vs employee based on behavioral, financial, and relationship controls
State Medical Practice Acts: State-specific laws governing the practice of medicine, including licensing requirements and scope of practice limitations
Corporate Practice of Medicine: State-specific laws restricting the practice of medicine by corporations and employment of physicians by non-physician entities
Medical Malpractice Laws: State-specific laws governing professional liability and standards for medical negligence claims
OIG Compliance Guidelines: Federal guidelines for healthcare organizations to establish effective compliance programs and prevent fraud/abuse
HIPAA Privacy Rule: Federal regulations establishing national standards for the protection of individuals' medical records and other personal health information
HIPAA Security Rule: Federal regulations setting national standards for securing electronic protected health information
Fair Market Value Requirements: Legal standards ensuring compensation arrangements reflect reasonable market rates and don't account for referral volume
Medicare/Medicaid Regulations: Federal regulations governing participation in and billing to federal healthcare programs
State Facility Regulations: State-specific requirements for healthcare facility operations, staffing, and compliance
Documentation Requirements: Legal and regulatory requirements for maintaining medical records, quality metrics, and reporting obligations
