Medical professionals are subject to much stricter standards than the general public. They require years of education to go into their profession and must maintain state licensing to work. Whether you are a primary care physician in a family-oriented office or someone who works as a general practitioner in the emergency room, you sometimes need to refer patients to other specialists or service providers.
For example, if someone presents with a significant knee injury, you may be able to provide them with diagnostic help and pain relief but will ultimately need to refer them to an orthopedic surgeon. If someone struggling with substance abuse comes seeking either prescription medications or mental health help, you may need to send them to an outside facility for rehabilitation services.
Unfortunately, if there are any connections between you and the facility or professional to which you make a referral, that could lead to allegations of a kickback arrangement.
What is a kickback?
There are federal and Minnesota state statutes prohibiting kickbacks for medical recommendations and references. A health care provider should make decisions about what treatment someone requires and where they receive that care based on what is best for the patient, not what will make the physician money or solidify their relationship with another professional or facility.
Sometimes, kickbacks are obvious. The surgeon that you referred a patient to buys you a watch or gives you an Amazon gift card to thank you for sending a patient who will need thousands of dollars of care from them. Other times, kickbacks can be more subtle or even occur off the books.
There may be a presumption of misconduct if investigatory agencies or the state licensing board can connect you directly to someone who works at or has an ownership interest in that outside facility or medical practice.
What could accusations of kickbacks mean for you?
The biggest concern when someone accuses a medical professional of accepting a kickback is that they could face criminal prosecution. If the situation involved interstate transactions, like claims against federal insurance coverage, there could be federal criminal charges brought against the health care professional.
Even state charges can have a lasting impact on someone’s career, not the least of which is that they could face a disciplinary hearing from the licensing board. Knowing what might constitute a kickback can help you avoid allegations of white-collar crimes as a health care professional.