April 14, 2015

Question:

Jennifer,

We have developed a number of strategic partnerships referring to our practice.  I would really like to compensate them because it just makes sense.  I should be able to incentivize!  Can I?  (If it helps, we have a totally out of network practice...)

Hopefully submitted, 
Dr. I

Answer:

Well, I'm glad you asked instead of implemented!  No, you cannot pay for referrals, per referral, percentages based on net collections based off of referrals, nada!  The big statute most people know about is the Federal Anti-Kickback Statute, which rightfully identified, prohibits referrals involving Medicare money - so here the out of network does make a difference.  But, do you take assignment of benefits?  Do you provide any covered/reimbursable services?  Regardless of the answer, most states prohibit remuneration for referrals, so irregardless of participation status, NO you cannot pay for referrals in most jurisdictions.  Failure to abide by the prohibition has a host of very negative potential ramifications - licensure impact and potentially criminal proceedings. 

If you are hiring an individual to perform marketing services, you can do that so long as compensation is structured appropriately.  Happy to help on that arrangement. 

 
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