MAY I GIVE GIFTS TO PATIENTS TO THANK THEM FOR REFERRING NEW PATIENTS TO MY OFFICE?
Q.: MAY I GIVE GIFTS TO PATIENTS TO THANK THEM FOR REFERRING NEW PATIENTS TO MY OFFICE?
A.: No. Both state and federal law prohibit providers from compensating other persons in any amount or form in exchange for referring patients to the provider.
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State Law
Under Illinois law, the Illinois Medical Practice Act prohibits a physician from dividing, sharing or splitting any fee for professional services with any person in exchange for a referral. If the gift or cash is construed as a division or sharing of fees, the physician’s license may be disciplined.
225 ILCS 60/22.2(a) states “A licensee under this Act may not directly or indirectly divide, share or split any professional fee or other form of compensation for professional services with anyone in exchange for a referral or otherwise […]”
Federal Law
Under federal law, offering gifts or cash in exchange for referrals could be construed as an illegal “kickback,” or payment to the referring individual of a portion of the medical charges. The Federal anti-kickback statute makes it a criminal offense to knowingly and willfully offer, pay, solicit, or receive any remuneration to induce, or in return for, the referral of an individual to a person for the furnishing of, or arranging for the furnishing of, any item or service reimbursable under a Federal health care program
What About the $15 and $75 Exceptions?
The OIG Gifts and Inducement exceptions do not apply to gifts for referrals. In short, giving gifts as compensation for referrals is distinguished from giving gifts to a patient where no referral is involved. For Medicare and Medicaid recipients, federal law allows providers to offer one-time gifts that have a retail value of $15 or less or no more than $75 per year in the aggregate. Therefore, you are permitted to offer gifts to Medicare and Medicaid patients if the gifts do not exceed these amounts and are not given in exchange for a referral.
What About Gifts of Services or Coupons for Services?
Gifts such as coupons for free exams, 30-minute massages, adjustments, and x-rays would also violate both state fee splitting and federal kickback statutes. Neither distinguishes between cash, items, or services. In fact, the Medical Practice Act fee-splitting prohibitions are broad and include “other form[s] of compensation.”
In addition, offering discounted or free examinations and x-rays could place you out of compliance with other provider network contracts you have signed.
What Can I Give My Patients to Thank Them?
The ICS believes the best practice is to send a thank you note or card for referrals. Since the thank you note does not have value other than the intrinsic value of the gesture, it would not violate state or federal law. However, the note should NOT mention the referred patient’s name, because any specific mention of another patient would be a violation of HIPAA privacy laws.
