How to Get Referrals and Stay Compliant

Establishing and maintaining relationships with both patients and referring providers is essential to your financial success. Therefore, it makes sense to consider all means to promoting your practice. However, some of those means can get you in trouble.

Dinners, Gifts, and Discounts

The Federal Anti-kickback Statute is a criminal law that, “prohibits the knowing and willful offer, payment, solicitation, or receipt of remuneration to induce federal healthcare programs.”¹ It’s illegal to give or accept anything of value if the intent is to generate referrals for services covered by government healthcare programs. The stakes are pretty high – violation can result in civil and criminal penalties, fines and exclusion from federal healthcare programs, like Medicare and Medicaid. Most states have Anti-kickback statutes as well, so it’s important to consult with a state health law attorney when in doubt.

The stakes are high as violations can result in civil and criminal penalties, fines and exclusion from federal healthcare programs, like Medicare and Medicaid. Most states have Anti-kickback statutes as well, so it’s important to consult with a state health law attorney when in doubt.

The Stark Law, “prohibits physicians from making referrals… for designated healthcare services to entities in which the physician has an ownership or financial incentive.”² These guidelines and limitations on gift giving are enforced by CMS and carry civil penalties for violations made with knowing intent.

Intent, Spending, and Gray Area

There’s a gray area when it comes to intent. For example, if you take a team of physicians out to lunch to talk about how you can obtain more referrals, then you’d be providing a gift (lunch) in return for referrals in violation of the Anti-kickback Statute. If instead, you used the lunch to discuss new therapeutic options available at your facility, then the intent is not to generate referrals but rather to educate and inform. See how it can get confusing?

After hearing all this, it might be tempting to prohibit giving or receiving anything of value to or from referring providers entirely. But with legal guidance from your general counsel and a state health law attorney, you can establish guidelines and policies that outline risks, exceptions and acceptable practices.

When in doubt, it’s best to seek legal counsel, and remember that in general:

• Modest spending + Intent to educate and inform = Legal
• Extravagant spending + Intent to generate referrals = Illegal

Keep Your Schedule Filled

There are lots of ways to generate referrals that don’t rely on any sort of gift giving. These four simple tips will strengthen your relationships with both existing and new referral sources to keep your schedule filled, all while maintaining compliance.

1. Build Relationships

   Network with diverse groups of clinicians in environments that allow you to demonstrate your skills and share your strengths as a clinician. The more well-known you are, the greater your opportunity for referrals.

2. Demonstrate Value

   Distribute a patient satisfaction survey to automatically gather actionable feedback and better understand your patient’s perception of care and manage their experiences.

3. Use Social Media

   Nearly seven in ten people in the United States have a social media presence.³ Social media is a powerful tool for generating word-of-mouth referrals and expanding your brand awareness.

4. Keep in Touch

   It can be as simple as a thank you note after a referral or a quick monthly check in. Keeping in touch with people who refer patients to your practice is a huge way to sustain an inflow of new patients.

A steady stream of patient referrals is essential to the financial success of your practice. In doing so, it’s important to remain in compliance. Our suite of easy to assign courses can ensure that your facility has the tools and information to remain in compliance so that you can focus on improving lives.