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Clinical Research Billing and the Law: Tips for Compliance

In the article: Clinical research billing and the law: Tips for compliance, authors Douglas Schoeneman and Tara Krieg discuss three key statutory regulations implicated in clinical research include: The False Claims Act, Stark Law, and The Anti-Kickback Statute.

Takeaways

  • NCD 310.1 provides guidance on Medicare coverage of research services. For any items or services to be potentially billable to Medicare, a study must meet Centers for Medicare & Medicaid Services qualifying criteria.
  • Medicare will pay for certain “routine costs” in a qualifying clinical trial.
  • Key statutory regulations implicated in clinical research are the False Claims Act, Stark Law, and the Anti-Kickback Statute.
  • When in doubt about compliance with the Anti-Kickback Statute, a party can request that the Office of Inspector General write an advisory opinion.
  • Proactively review areas at risk for noncompliance to ensure research protocols are being conducted in compliance with federal laws and regulations.

Read the full article: https://bit.ly/3JSPBRs

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