Policy: This Anti-Kickback Statute Policy requires NTSOC’s compliance with the Federal Anti-Kickback Statute and analogous state laws. In addition, it is designed to ensure that all NTSOC employees and contractors understand:

• The elements of the Anti-Kickback Statute; and
• The obligation to report violations and/or seek guidance, where necessary.

This Policy is applicable to all NTSOC business transactions and practices that could implicate the Anti-Kickback Statute and to all NTSOC employees and contractors engaged in such transactions or practices.

Compliance with the Anti-Kickback Statute: NTSOC is committed to conducting its business transactions and practices in compliance with the Anti-Kickback Statute and analogous state laws. All NTSOC employees and contractors shall comply with the requirements of the Anti-Kickback Statute as well as all related NTSOC company policies and procedures. This means that NTSOC employees and contractors shall not give, receive, solicit or help arrange anything of value as part of the process of obtaining or making referrals in violation of the Anti-Kickback Statute or state law. NTSOC employees and contractors shall report suspected violations of the Anti-Kickback Statute and/or related company policies and procedures consistent with NTSOC Compliance Policies and the NTSOC Code of Conduct.

In addition, NTSOC employees and contractors may direct any questions regarding the Anti-Kickback Statute and related NTSOC company policies and procedures to the Compliance Officer or the Administrator. If, after discussions with these individuals where the response is not satisfactory, NTSOC employees and contractors should contact a member of the Board of Directors. If the complaint or questions involves the conduct of the Compliance Officer or Administrator, the employee or contractor should contact a member of the Board of Directors.

Failure to comply with this Policy may result in:

• disciplinary action, up to and including termination of employment, for Employees; or
• termination of the contractual arrangement, for Contractors.

• Prohibited Transactions and Practices
• The Anti-Kickback Statute prohibits anyone from knowingly and willingly offering, paying, soliciting, or receiving any remuneration intended to induce:
• The purchase, lease, order, or recommending or arranging for the purchase, lease or order of an item or service that is reimbursed under a Federal Health Care Program; or Referrals for an item or service that is reimbursed under a Federal Health Care Program.

In evaluating whether any particular business transaction or practice violates the Anti-Kickback Statute, the government may consider whether the transaction or practice has the potential to:

1. increase costs to a Federal Health Care Program, beneficiaries, or enrollees;
2. increase the risk of over-utilization or inappropriate utilization;
3. raise patient safety or quality-of-care concerns; or
4. interfere with appropriate clinical decision making.

Remuneration means anything of value given, directly or indirectly, overtly or covertly, in cash or in kind, to a Customer and includes, but is not limited to:

1. cash;
2. free goods;
3. free services; and
4. payment for items, services or data at above fair market value.

Because the federal government may construe the Anti-Kickback Statute broadly to prohibit otherwise beneficial business transactions or practices, it created “safe harbors” to shield certain transactions and practices from prosecution under the statute.

To receive the protection of a safe harbor, a transaction or practice must satisfy each element of a safe harbor. Transactions or practices that do not satisfy all elements of a relevant safe harbor are not necessarily illegal but may be subject to heightened scrutiny.

To the extent possible, company business transactions and practices should comply with an applicable safe harbor. Employees and Contractors should consult with Legal Counsel and the Compliance Officer for advice on satisfying the requirements of a safe harbor.

The Anti-Kickback Statute is an intent-based statute. However, the Anti-Kickback Statute may be violated if one purpose of the business transaction or practice is to induce referrals or the purchasing, leasing, or ordering of any item or service, or the recommending of or arranging for such activities, even if there are other legitimate purposes for the transaction or practice.

The Anti-Kickback Statute is a criminal statute, the violation of which constitutes a felony punishable by:

• a fine of not more than $25,000 per offense; and/or
• imprisonment for up to five years.

A conviction also will lead to mandatory exclusion from participation in Federal Health Care Programs. The Office of Inspector General (“OIG”), Department of Health and Human Services, also may impose civil monetary penalties of up to $50,000 for each violation, plus damages of three times the amount of the remuneration.

The Anti-Kickback Statute applies not only to NTSOC, but also to its Employees, Contractors, Clients, Patients, Families and Students.