What the Law Says About Referral Kickbacks in Health Care
An overview of the Anti-Kickback Statute and Stark Law for physicians in Colorado
By S.M. Oliva | Last updated on January 26, 2023Use these links to jump to different sections:
Have you ever offered the host or hostess at a restaurant a $20 bill to get you a good table? This is, essentially, a kickback. And while such behavior may go unnoticed in the food service industry, when it comes to health care, kickbacks are a much more serious affair. Indeed, there are federal and Colorado state laws that expressly forbid health care providers from accepting or soliciting kickbacks. The laws, combined with related regulations are certainly comprehensive and have made health care providers more attentive to the nature of their referral relationships with others,” says Kari Hershey, an attorney in Littleton.The Federal Anti-Kickback Statute

The Stark Law and Physician Self-Referrals
A close cousin to the 1972 anti-kickback statute is the Stark Law. First adopted by Congress in 1989, the Stark Law deals with “self-referrals” by physicians and other health care providers. A self-referral means the provider refers a Medicare or Medicaid patient to a “designated health service” in which that provider, or an immediate family member, has a financial interest. For example, if a doctor refers a Medicare patient to a clinical laboratory that is co-owned by the doctor’s son, that would qualify as a Stark Law violation. Although Stark violations can result in heavy fines—as well as possible expulsion from Medicare or Medicaid—there are a number of exceptions that may protect an individual health care provider from liability. But it is important to consult with a qualified Colorado health care attorney before assuming these exceptions apply to your situation. For more information on this area of law, see our overview of health care law.What do I do next?
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