While the United States’ healthcare system has many wonderful advantages and advancements, it is far from perfect. One persistent problem has been the influence of money on medical decisions.
Unfortunately, there are unscrupulous doctors and companies who prioritize money over patient health and enter into kickback arrangements to pad their profits.
Because of these threats, our nation has the Anti-Kickback Statute, which outlaws paying or receiving anything of value in exchange for healthcare referrals.
What Is the Anti-Kickback Statute?
The Anti-Kickback Statute (AKS) is a federal law prohibiting the exchange of anything of value to influence the referral or receipt of federal healthcare program benefits.
The AKS applies to a number of federal programs, including:
- Medicare: coverage for older individuals or people with disabilities;
- Medicaid: coverage for individuals with limited finances; and
- TRICARE: coverage for members of the armed forces and their families.
In simple terms, the law says that no one can: solicit, pay, offer, or accept money or gifts in return for patient referrals or services covered by federal healthcare programs.
Violating the AKS is a criminal offense. It can lead to hefty fines, jail time, and exclusion from federal programs.
What Is a Kickback in Healthcare?
Kickbacks in healthcare are payments made to influence decisions about medical treatment or services.
A kickback can include:
- Cash payments or gifts;
- Free vacations or tickets;
- Sham consulting or speaking engagements;
- Discounts or rebates with no legitimate purpose; and
- No-cost office space or other benefits.
Any exchange of something of value for dishonest healthcare practices can be illegal. If the payment is linked to patient referrals or the use of certain federal services, it may violate federal law.
Kickbacks in healthcare distort clinical decision -making and increase costs. They also hurt honest providers and patients who trust the system to work for them.
Why Kickbacks in Healthcare Are So Dangerous
Healthcare kickbacks hurt everyone.
Patients receive unnecessary or even harmful treatments, taxpayers fund fraudulent claims, and dishonest actors undercut trustworthy providers.
The Department of Justice takes violations seriously and aggressively pursues AKS violations. National takedowns have led to many criminal charges and civil penalties against bad actors in the system.
How the Anti-Kickback Statute Works with the False Claims Act
The False Claims Act is another key statute used to stop government fraud. It allows whistleblowers who know of fraud against the federal government to file lawsuits on the government’s behalf.
When a provider violates the Anti-Kickback Statute, it often leads to the filing of false claims. For example, if a doctor gets kickbacks and then bills Medicare, those claims are legally considered false and not reimbursable fraudulent — even if the medical service was actually performed.
Healthcare fraud hurts patients, endangers lives, wastes resources, and erodes public trust. If you’ve seen questionable referral arrangements or improper payments tied to federally funded healthcare, we can help you take the next step.
Reese Marketos LLP is one of the nation’s leading trial firms for False Claims Act and whistleblower litigation, with some of the most significant recoveries in U.S. history. Our lawyers know how to protect whistleblowers and maximize their reward. If you’re considering reporting fraud, we can help.
More Resources:
- U.S. Department of Health and Human Services, Office of Inspector General, “Fraud & Abuse Laws,” link.
- U.S. Department of Justice, Civil Division, “The False Claims Act,” link.
- Justice.gov, National Health Care Fraud Takedown Results in Defendants Charged in Connection with Over $14.6 Billion in Alleged Fraud (June 30, 2025), link.
- Medicaid.gov, “Eligibility Policy,” link.
- U.S. Department of Health and Human Services, “Who’s eligible for Medicare?” link.
- United States Attorney’s Office, Eastern District of Arkansas, Doctor and Sales Rep Charged with $12 Million Fraud Scheme Targeting Tricare and Extensive Cover Up (January 10, 2020), link.