One common goal healthcare professionals and facilities have, just like many other professionals and businesses, is customer satisfaction. Every doctor, hospital, and other facilities that provide healthcare services in one way or another seek to provide their patients with the best possible services. The reasons for this vary from complying with their professional code of conduct to profit-making, building a strong reputation, and of course, getting referrals from other providers.
It is well established and founded that more often than not, one healthcare provider is unable to attend to all the needs of a patient and would have to refer such a patient to other providers in order for the patient to get the best treatment possible. As great as this sounds, patient referral does have its challenges and laws have been put in place in Florida and at the federal level to avoid these challenges. These laws are referred to as the Anti-Kickback laws and codified in various applicable statutes in the state of Florida. The Florida Anti-Kickback Statutes will be discussed briefly in this article.
A kickback, generally speaking, is a practice where a business or an individual professional pays someone to get referrals and/or pays a commission for the increased transactions as compensation for referrals. In the healthcare industry, it is where healthcare providers refer patients to one another in exchange for monetary compensation, a positive outcome, or a favorable decision.
The Anti-Kickback Statutes in Florida seek to prohibit illegal referrals of patients between healthcare professionals and facilities for financial reasons. The receipt of kickbacks broadly includes anything of value such as cash payments, gifts, favors, etc. This law applies to all Florida healthcare service providers including but not limited to hospitals, physicians, dentists, pharmacists, and nursing homes. The statutes ensure that the physicians or health care providers make referrals that are in the best interest of the patients and not the physicians’ wallets. The statutes seek to discourage physicians from making referrals to inappropriate or unnecessary medical services for personal benefits and by extension, minimizes the fraud on the government.
Anti-Kickback laws apply to all healthcare providers in Florida including, but not limited to:
All healthcare professionals should have a clear understanding of the outbound or inbound referral patterns that could make them susceptible under the Florida Anti-Kickback Statutes as there are criminal and civil liabilities for non-compliance.
Kickbacks can take many different forms and while some are obvious, like accepting money in return for referrals, others can be less obvious like a hospital giving lower rent in return for patient referrals. It is easy to unintentionally run afoul of anti-kickback laws in Florida. It is however pertinent to note that unintentional violations can also be prosecuted as the statutes do not always require the act to be willful conduct.
The anti-kickback statutes that apply in Florida, both generally and specifically are as follows-
As the penalties under the anti-kickback laws of Florida are severe, health care providers and practitioners should work with an experienced Florida healthcare lawyer to make sure they have legitimate relationships and are compliant with the laws and regulations guiding their practice.
At Imudia Law, our philosophy is ‘prevention is better than cure.’ Let us help you be compliant with the Florida Anti-Kickback Statutes by reviewing your current referral policy and drafting a revised plan as needed.