State and federal prohibitions of referral fees have long plagued the health care sector because their broadly worded provisions threaten established and socially valuable business arrangements. Congress has recently instructed the Department of Health and Human Services to issue regulations that clarify the scope of the most threatening of these prohibitions, the Medicare and Medicaid felony referral fee statute. This article examines three possible analytical models for imposing a limiting construction on referral fee statutes by testing the models against three beneficial practices that the statute jeopardizes: physician recruitment, fee discounting, and efficiency bonuses. The article recommends primary reliance on an earned/unearned analysis that detects a prohibited referral fee by asking whether the fee is fully earned by legitimate, nonreferral services.
Skip Nav Destination
Research Article| August 01 1988
Making Sense of Referral Fee Statutes
J Health Polit Policy Law (1988) 13 (4): 623–633.
Mark A. Hall; Making Sense of Referral Fee Statutes. J Health Polit Policy Law 1 August 1988; 13 (4): 623–633. doi: https://doi.org/10.1215/03616878-13-4-623
Download citation file:
Don't already have an account? Register
You could not be signed in. Please check your email address / username and password and try again.
Could not validate captcha. Please try again.
Sign in via your InstitutionSign In
Citing articles via
Are black workers missing the connection? The effect of spatial distance and employee referrals on interfirm racial segregation
Efforts to Improve Patient Safety in Large, Capitated Medical Groups: Description and Conceptual Model