In some industries, rewarding those who refer business to you is acceptable.
However, paying for referrals for federal health care program business is a crime.
If you’re a healthcare provider who owns a healthcare business, it is important to be aware of the federal anti-kickback statute and what it means for your business.
In Texas, the anti-kickback statute applies to all healthcare providers, including hospitals and physicians.
If you have any questions, please contact us today.
What Is the Anti-Kickback Statute?
The Texas anti-kickback law imposes criminal penalties on anyone improperly offering to exchange anything of value that might encourage or induce a referral of business from a federal healthcare program.
Federal healthcare programs include Medicaid and Medicare.
The purpose of the law is to prevent healthcare providers from making decisions based on financial gain rather than patient care.
It prohibits any financial arrangement in which a healthcare provider pays or receives money, gifts, or other incentives in exchange for referring patients to other providers or for using certain medical products or services.
Enforced by the Texas Attorney General’s Office and the Department of Justice, the anti-kickback law is one of the most important tools in the government’s enforcement arsenal to combat healthcare fraud.
Violations of the statute can result in criminal charges, civil penalties, and exclusion from government healthcare programs.
Avoiding these severe penalties through careful planning and working with a trusted attorney should be the first thing you consider when pursuing transactions involving physician-owned entities.
How to Avoid Violating the Texas Anti-Kickback Statute
To avoid violating the anti-kickback statute, healthcare providers in Texas should avoid any financial arrangements that could be construed as kickbacks.
Prescribing certain medications, using certain medical products, or receiving gifts or money for referrals could be considered kickbacks.
Additionally, healthcare providers should work closely with legal and compliance professionals to ensure that any financial arrangements they enter into are fully disclosed and compliant with all applicable laws and regulations.
Providers should also ensure that any payments received are fair market value for their service and not influenced by any referrals or other business opportunities.
Sometimes, healthcare providers may participate in certain financial arrangements exempt from the statute.
These exemptions include arrangements involving risk-sharing agreements, certain discounts on medical services or products, and certain referral arrangements involving healthcare providers employed by the same entity.
To ensure compliance, providers should work closely with legal and compliance professionals to ensure that all financial arrangements are fully disclosed, comply with all applicable laws and regulations, and are based on fair market value for the services provided.
If you’re unsure whether your arrangement violates the anti-kickback statute or any other applicable healthcare law, it is imperative to contact an attorney.
Get in Contact with an Anti-Kickback Statute Attorney Today
The healthcare lawyers at Massingill Attorneys & Counselors at Law have an in-depth understanding of the anti-kickback statute and all other laws, rules, and regulations that govern physician business ownership.
We use this knowledge to help individual providers, hospitals, healthcare facilities, MSOs, and healthcare entrepreneurs understand how these restrictions affect their businesses.