US Court Broadly Interprets Referral under Anti-Kickback Statute

March 6, 2015 | Strategic Insights for Ambulatory Care


​The U.S. Seventh Circuit Court of Appeals has broadly interpreted what constitutes a "referral" under the Anti-Kickback Statute by concluding that a physician only needs to authorize and facilitate a patient to undergo a recommended treatment or procedure in order to have made a referral. The federal court hears appeals from courts in Illinois, Indiana, and Wisconsin. In the case, a physician was charged with six counts of violating the Anti-Kickback Statute when federal investigators found that he was receiving undisclosed payments from a home care company used by several of his patients. The physician frequently recommended home care to his patients, and one of his staff members provided a list of home care companies for patients to consider. The physician argued that he had not "referred" any patients to the company because he did not steer or direct them to any particular provider.

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