Under this statute, a primary element that must be proven is the intent to defraud a health care benefit program. If someone accused of Medicare fraud lacks the specific intent to defraud a federally funded health care benefit program, the government may not be able to demonstrate the commission of a crime.

Anti-kickback Statute (AKS)

One of the more common defense to Medicare fraud charges under the Anti-kickback Statute, 42 U.S. Code § 1320a–7b, requires proving that the alleged unlawful business transaction was not prohibited under the “safe harbor” provisions of the statute. The safe harbor provisions of the Anti-kickback Statute protect certain types of transactions such as investments, referral of certain services, relationships between providers of healthcare services, arrangements between healthcare service providers and health insurance plans, and the character of the relationship between providers and suppliers.