An illegal kickback in healthcare refers to a violation of the federal Anti-Kickback Statute (AKS). The AKS prohibits medical providers from paying or receiving anything of value in exchange for referrals of patients who will receive any item or service paid for by a government healthcare program such as Medicare and Medicaid. As an example, a nursing home that pays a doctor money to refer his Medicare patients to the nursing home likely violates the AKS. The AKS is a very broad statute, and it applies to all individuals and companies.
There are several exceptions or “safe-harbors” that can make it difficult to determine if a certain type of financial relationship is in fact a violation of the AKS. The AKS is also similar to the physician self-referral law (known as the Stark Law). An experienced False Claims Act attorney should be consulted to determine if a possible kickback is in fact illegal under the AKS.