Almost every significant healthcare fraud prosecution in the Riverside area has a referral arrangement somewhere in the file. A marketer paid per patient. A facility director who gets a monthly stipend. A doctor whose “consulting” checks track admissions. Prosecutors call it remuneration; the people involved usually called it marketing. My Rights Law Criminal Defense and DUI Lawyers defends Riverside providers, clinic owners, and marketers accused of paying or receiving kickbacks for patient referrals — called patient brokering or body brokering when it involves recruiting people themselves. This page explains the statutes, the safe harbors, and how these cases are actually defended.
Two systems criminalize referral payments. Federally, the Anti-Kickback Statute — 42 U.S.C. section 1320a-7b — makes it a felony to knowingly and willfully pay or receive remuneration in return for referring federal healthcare program business, or to induce purchases of items or services covered by those programs. In California, Business and Professions Code section 650 makes it unlawful for a licensee to pay or receive anything of value for referring patients, prospective patients, or clients, with parallel felony provisions in Penal Code section 550.2 for insurance-funded care. The same contract can violate all of them at once.
Remuneration is anything of value, and it is rarely just cash:
What distinguishes a lawful arrangement from a crime is not the label on the contract — it is whether payment tracks referral volume or value, and whether the arrangement fits within regulatory safe harbors.
The Anti-Kickback Statute is drafted broadly, and Congress directed HHS to publish safe harbors — regulatory specifications that, if met, protect an arrangement. Investment interests, rental agreements, personal services contracts, and employee compensation all have safe harbors with strict requirements: fair market value, commercial reasonableness, and — critically — payment that does not vary with the volume or value of referrals. Arrangements outside a safe harbor are not automatically illegal; they are judged on intent. That intent analysis is the battleground of every kickback case.
Federal referrals surface through audits, data analysis, former employees, and the government’s growing use of data matching between payer records and marketing contracts. Wire charges often attach because payments move by check or transfer. Once one party cooperates, the referral chain — marketer, clinic, physician — is charged together. State Medi-Cal versions are prosecuted by DMFEA and filed at the Riverside County Superior Court’s Riverside Hall of Justice at 4100 Main Street; federal kickback cases go to the Central District of California. Convictions carry prison, exclusion from Medicare and Medi-Cal, and board discipline.
The one-time purchase statute — 42 U.S.C. section 1320a-7b(b) — also contains exceptions for certain isolated transactions, and state law has its own exceptions for specified employment and billing structures. Whether any exception fits is a legal question that should be analyzed before, not after, charges.
Get help now for your Riverside referral or kickback case.
When the patient’s care is billed to Medicare, Medi-Cal, or any insurance carrier, per-patient compensation for referrals is exactly what these statutes target. Structuring patient acquisition lawfully requires counsel before the contract is signed.
Receiving remuneration for referrals is also a crime — both sides of the transaction are charged. If you were offered or accepted anything of value connected to patient flow, get advice before agents raise it first.
Have a healthcare lawyer structure it to a safe harbor before any money moves. Retroactive fixes cannot undo a payment that already occurred.
This page is legal information, not legal advice, and reading it does not create an attorney-client relationship. Laws and enforcement priorities change, and outcomes depend on the facts of each case.
Riverside office: My Rights Law Criminal Defense and DUI Lawyers - Riverside, 3600 Lime St #424, Riverside, CA 92501. Call 888-702-8882 for a free confidential consultation.
This page was written by the My Rights Law Editorial Team and reviewed for legal accuracy by Bobby Shamuilian.
Attorney Shamuilian is the founder and managing partner of My Rights Law and is widely recognized as a legal authority, frequently appearing as a legal analyst and TV pundit on national news outlets.
He has earned a perfect “10.0 – Top Attorney” rating on AVVO and a “10.0” rating on Justia, and has been named among the “Top 40 Under 40” and the “Top 100 Trial Lawyers” by The National Trial Lawyers.
With his proven expertise and dedication, Mr. Shamuilian is committed to protecting your rights and achieving the best possible outcome for your case.
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