New Statute Prohibits Kickbacks in Recovery Services
A new federal statute imposes criminal penalties for kickbacks related to addiction recovery and related services.
The Eliminating Kickbacks in Recovery Act (“EKRA”), passed last October as part of the anti-opioid SUPPORT for Patients and Communities Act, creates additional compliance requirements for substance abuse recovery homes, clinical treatment facilities, and laboratories, as well as for the health care providers or others who refer patients to them. Specifically, EKRA prohibits remuneration related to referrals of an individual to a recovery home, clinical treatment facility or laboratory or their services, where such services are paid for by a health care benefit program.
- While the Anti-Kickback Statute applies only to referrals paid for by a federal benefit program, EKRA is not limited to federal payers. Instead, services paid for by private insurance also fall under this statute.
- The inclusion of laboratories in EKRA is not limited to laboratories providing services related to substance abuse. Therefore, contracts with any type of laboratory providing health-care-related testing services should be reviewed for compliance with EKRA.
- Exceptions to EKRA are similar to the Anti-Kickback Statute’s safe harbors, though EKRA contains additional exceptions as well. Any arrangement that could implicate EKRA should be reviewed to determine whether an exception applies, including:
- Contracts or unwritten arrangements with recovery homes and clinical treatment facilities
- Contracts or unwritten arrangements with laboratories
- Employment agreements and/or compensation arrangements between recovery homes, clinical treatment facilities and laboratories, and their respective employees
- Violation of EKRA is punishable by a fine of not more than $200,000, imprisonment of not more than 10 years, or both for each occurrence.
For assistance with determining whether any of your practices need to change in response to EKRA, contact Lora L. Zimmer or your McCarty Law attorney.
Lora L. Zimmer
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