Self-Referral and Anti-Kickback Laws

Much has been written about "self referral” and "kickbacks” in health care. Stated simply, health care providers may not make referrals to entities in which they have a financial interest, and they may not pay for referrals or receive "kickbacks” (commissions) for referring patients to other providers. Concerns about overutilization and inappropriate treatment plans have led federal and state governments to pass a tapestry of laws prohibiting these practices. The intent of these laws is to ensure that providers who order tests and treatments for patients are not motivated by profit over professionalism.

Unfortunately, the laws are extremely complex and voluminous. Most doctors have a sense that these rules apply to contracts with physicians in the office but simply don’t know how these laws translate to their physician agreements. While it is not possible in one article to summarize all of the regulations, most of their impact in the chiropractic office occurs in contracts with other physicians in the practice, either as salaried employees, independent contractors or physicians to whom the owner physician has leased office space. Therefore, it is advisable to be aware of the most basic requirements and prohibitions if you participate in these types of arrangements.