Healthcare law specialists: Use caution when speaking to potential referral sources

Imaging providers should always be cautious when approached by a personal injury attorney about potential business, according to a new blog post on Link, the AHRA newsletter. Pursuing such opportunities could cause the specialist in question significant issues.

“Most providers understand that for Medicare and Medicaid patients, these types of arrangements could violate the federal Anti-Kickback Statute,” wrote authors Adrienne Dresevic, esq., and Robert Dindoffer, esq., of the Health Law Partners in Southfield, Michigan. “However, even when auto insurance or other insurers are involved, state laws oftentimes prohibit these types of financial relationships between providers/suppliers and their referral sources.”

Dresevic and Dindoffer reminded readers that payers are under “increased scrutiny” when it comes to such transactions. What might seem like a harmless referral could be considered a serious violation. States are paying more and more attention to such referrals, creating harsh legislation with harsher penalties.

“For example, California has adopted an all-payer, anti-kickback law that generally prohibits physicians and other licensed professionals from paying or receiving compensation in return for referrals of patients,” they wrote. “In Michigan, the Health Care False Claim Act makes it illegal for a health care provider to pay a kickback or bribe to anyone in connection with the furnishing of services that are paid for by most insurers.”

Dresevic and Dindoffer added that imaging providers must remain vigilant when it comes to scrutinizing potential financial dealings with any referral sources. “Whenever an imaging provider is presented with the opportunity to enter into a financial arrangement with a potential referral source, it is highly advisable to consult with counsel,” they concluded.