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ARTICLE · 29 SEPTEMBER 2000

Identifying Fraud And Abuse Concerns In eHEALTH Commerce

Davis Wright Tremaine LLP
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United StatesAccounting and Audit

By Diane M. L. Lee

As the pace of commerce and communications over the Internet grows, buyers and sellers, as well as the intermediary organizations that facilitate transactions between buyers and sellers, must be careful not to engage in transactions that violate fraud and abuse laws. By "fraud and abuse" we refer generically to a number of federal and state laws, including the following1

  • Anti-kickback laws
    • (see page 4) prohibit the payment, receipt, offer or solicitation of remuneration in exchange for the referral, recommendation or generation of healthcare goods and services. Generally, remuneration is defined broadly to include any direct or indirect economic benefit, including kickbacks, discounts, rebates, relief from financial obligations (such as interestfree loans), gifts and gratuities. Commonly accepted business practices such as preferential pricing on bundled goods and services, providing rebates based on volume, below cost pricing, free goods and services, and

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