Administrative law is a branch of law that governs the activities of administrative agencies of government. These agencies, often referred to as regulatory agencies or administrative bodies, are created by legislative bodies to carry out specific functions, such as rulemaking, enforcement, and adjudication. Administrative law sets out the legal framework for the establishment, powers, and procedures of these agencies.
In terms of Health Care Law, it is imperative to mention The Florida Agency for Health Care Administration, also known in short as AHCA. Its overall mission is "Better Healthcare for All Floridians". AHCA oversees health care entities in Florida and lays out the parameters for things like licensing, regulations, and compliance. Furthermore, AHCA actively conducts audits on health care entities to ensure that they are not defrauding Medicare and Medicaid programs. These audits have the potential of opening up an entity to investigations for violations of the AKS.
Florida Agency for Health Care Administration (myflorida.com)
In terms of administrative law the directly oversees issues under the Anti-Kickback Statute, look no further than the Office of Inspector General. The OIG is tasked with identifying and investigating certain federal issues. In these cases, an alleged violation will prompt the OIG to audit a health care entity and request certain documents that are relevant to the claim. Once the investigation is complete, the OIG will determine what penalties are appropriate under the statute. These penalties can include monetary fines, criminal convictions, revocation of licenses, and mandatory exclusion from health care programs like Medicare and Medicaid.
It is often recommended that health care entities partake in what is called "self-reporting". This is when the entity realizes, on its own accord, that it is committing some sort of federal violation. This can be in the form of a violation of the AKS. Once this happens, the entity can report itself to the OIG and open itself up to an investigation. In many cases, the OIG will come down with less harsh penalties if the entity is the one who reports itself.
