Some examples of common kickbacks in the healthcare industry include:
Any gift of above nominal value, including things such as food, event tickets, and gift cards, is an improper kickback. If the purpose of giving the gift is to induce or reward referrals or preferential treatment for goods or medical services, this is considered a kickback. Also, providing gifts to physicians referring patients can, by itself, create an improper financial relationship between the referring physician and the entity providing the gift under the Stark Law.
Bribes are straightforward types of kickbacks in which money or something of value is given specifically for the purpose of receiving preferential treatment. Beyond straight payments, healthcare providers and companies often disguise bribes as legitimate payments to physicians or other decision makers. A common way to do this has been to pay inflated rates for physicians to appear at speaking engagements.
Kickbacks can also occur through overbilling where a vendor submits inflated invoices for the goods or services it provided. A kickback is then provided, usually to a corrupt employee of the payor, for accepting and paying the excessive charges.
Diverting business to vendors
One of the most prevalent examples of kickbacks improperly influencing the decision of which vendor to use in the healthcare industry is when pharma companies provide remuneration for physicians to prescribe their products. As a result, physicians do not make medical decisions using their unbiased medical judgment, but rather choose to prescribe certain medicine to their patients for personal financial consideration.
Using payments or compensation to refer patient
Paying kickbacks for patient referrals is a very common violation and the reason the Stark Law exists. The government does not want patients being referred to other healthcare providers based on financial reward but rather what is in the best interest of the patient. By referring a patient to a certain healthcare provider in exchange for something of value, whether it be a direct payment or financial incentive due to ownership in the healthcare provider, this intent is subverted.
Conflict of Interest
Another common form of conflict is the involvement of family interests. In such case a spouse, a child, or another close family member is employed by the contractor, or goods and services are purchased from such a relative or the firm controlled by a relative.