Q&A: Illegal incentives

Q: I am a solo internal medicine physician with a concierge practice in Southern California. I would like to offer my patients an incentive for referrals-for instance, a percentage or dollar amount off their yearly concierge fee-but I was told that doing so would violate Stark laws. Is this true?

A: It is not Stark laws but the federal anti-kickback statute that makes such an incentive illegal, if your practice accepts patients covered by Medicare and bills Medicare (that is, hasn't opted out). Many state laws also prohibit kickbacks of this nature, without regard to whether Medicare is billed.