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Compliance & Privacy

Compliance Beyond HIPAA: Navigating Stark, Anti-Kickback, and the False Claims Act

Mark Wilson11 min read
Compliance Beyond HIPAA: Navigating Stark, Anti-Kickback, and the False Claims Act

Billing compliance is more than privacy. Stark, the Anti-Kickback Statute, and the False Claims Act carry serious penalties for getting it wrong.

HIPAA protects privacy, but a separate web of laws governs how you bill and refer. The Stark Law, the Anti-Kickback Statute (AKS), and the False Claims Act (FCA) carry steep civil and criminal penalties — and ignorance is not a defense.

Know the big three

  • Stark Law — limits physician self-referral for designated services
  • Anti-Kickback Statute — bars paying for referrals of federal-program business
  • False Claims Act — penalizes knowingly submitting false claims

Build a compliance program

An effective program — policies, training, auditing, and a way to report concerns — is your best defense and is expected by regulators.

How Aethera helps

Aethera bills to a documented compliance standard and audits for fraud, waste, and abuse risk, so accurate claims protect your revenue and your license.

Related resources

For the full picture, see our complete medical billing compliance guide, or explore Aethera’s compliance & auditing services.

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