“Kickbacks” to Medical Providers are Illegal
A “kickback” is a payment made with the intent of influencing an action or gaining something in return. Specifically, a Medicaid kickback is a payment, or other exchange of value, made in an effort to induce or reward the referral of Medicaid business to a health care provider. These kickbacks are illegal.
In 1977, Congress enacted the federal Anti-Kickback Statute, which criminalizes kickbacks for referrals of federal health care program business, including the Medicare and Medicaid programs. It is based on intent and requires that the party “knowingly and willfully” engage in the prohibited conduct. The purpose of this legislation is to address the concern that health care providers could be influenced to provide unnecessary or inappropriate medical services due to kickback payments.
Illegal kickback transactions can happen in numerous ways. Kickbacks may include:
- Kickbacks for member referrals.
- Kickbacks paid to patient recruiters.
- Medicare beneficiaries who receive kickbacks for visiting a health care provider and signing documents stating they received treatments that were either medically unnecessary or not actually provided.
- Homeless individuals staying at a health care facility not to receive medical care, but to receive kickback payments.
Kickback payments can happen in other ways as well. It is not uncommon for large-scale health care fraud schemes to include criminal charges of illegal kickbacks.
The Anti-Kickback Statute establishes penalties for individuals on both sides of the kickback transaction. This means that people or entities who either give or receive a kickback may be subject to criminal prosecution. Conviction for a single violation may result in imprisonment for up to 5 years and a fine of up to $25,000.
If you are being investigated for an alleged kickback transaction, or any health care fraud, it is imperative that you consult with an experienced health care fraud defense attorney. These types of allegations can cause significant damage to your personal and professional reputation and result in serious penalties.
As a former health care fraud prosecutor with the United States Attorney’s Office, Ashley D. Adams understands the government’s tactics and knows how to establish the best possible defense for your case. We know how to combat aggressive prosecutors. Contact us or call now (480) 219-1366 for a case evaluation.
The attorneys at Ashley D. Adams, PLC handles federal criminal cases throughout the United States, including Arizona, Oklahoma, Utah, and California.