Congress passed the Eliminating Kickbacks in Recovery Act (the Act) in 2018 to prevent “patient brokering” in treatment for substance abuse disorders. The Act imposes criminal penalties against anyone who knowingly and willfully “solicits or receives any remuneration . . . in return for referring a patient or patronage to a recovery home, clinical treatment facility, or laboratory” or who knowingly and willfully “pays or offers any remuneration . . . to induce a referral of an individual to a recovery home, clinical treatment facility, or laboratory; or in exchange for an individual using the services of that recovery home, clinical treatment facility, or laboratory.”

The Act applies to all payors, even where no Federal program dollars are at play. Penalties are harsh and may include a fine up to $200,000 and imprisonment for up to 10 years. Because the Act broadly defines the facilities that are subject to its restrictions, any entity or individual providing addiction-treatment and recovery services (even if only as a minor part of their service offerings) and clinical laboratories should evaluate arrangements with referral sources to ensure compliance with the Act.

To read the full GT Alert, click here.

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Photo of Julie A. Sullivan Julie A. Sullivan

Julie A. Sullivan is a health care regulatory and compliance attorney concentrating her practice on state and federal health care fraud, waste and abuse guidance, reimbursement matters, as well as health privacy and security law. She represents health care providers and suppliers in…

Julie A. Sullivan is a health care regulatory and compliance attorney concentrating her practice on state and federal health care fraud, waste and abuse guidance, reimbursement matters, as well as health privacy and security law. She represents health care providers and suppliers in complex regulatory and transactional matters, and routinely advises on issues such as corporate practice of medicine, fee splitting, licensure and certification issues including Medicare revocation, payment suspension and exclusion matters, and Medicare and Medicaid reimbursement disputes. Julie also structures mergers and acquisitions and value-based arrangements in the health care space to comply with the vast legal and regulatory requirements applicable to business deals in the health care industry, and leads regulatory due diligence and diligence remediation efforts in connection with such transactions in tandem with the corporate M&A teams at GT and other law firms.

Julie has deep experience in the intricate and involved processes associated with over-payment refund processes and self-disclosures. She routinely assists provider clients, including behavioral health providers, substance use disorder providers, hospitals and health systems, long-term care providers, dialysis providers, ambulatory surgery centers, and ancillary service providers with referral source relationship compliance issues and internal or government investigations into billing issues and the handling of such matters requiring refunds and/or self-disclosures to government-funded health care programs or regulatory agencies.