MARCH 2026 | 9 THE OKLAHOMA BAR JOURNAL Statements or opinions expressed in the Oklahoma Bar Journal are those of the authors and do not necessarily reflect those of the Oklahoma Bar Association, its officers, Board of Governors, Board of Editors or staff. Health Law In Health Care, What You Don’t Know May Hurt You By Cori Loomis and Luke Moyer HEALTH CARE PROVIDERS CANNOT PAY FOR BUSINESS GENERATION Paying for business generation is so commonplace that there are countless terms used to describe the practice: finder’s fees, referral fees, origination fees, sourcing fees, placement costs, etc. The list goes on. Some professions are sustained almost entirely on these types of fees. But in the context of federal health care programs, the U.S. Department of Justice (DOJ) and the U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG), use a markedly different word to describe those arrangements: fraud. The same types of arrangements that are ubiquitous in other sectors are prohibited by a federal criminal statute called the AntiKickback Statute (AKS),1 which makes it a felony offense for anyone to knowingly and willfully solicit or receive any remuneration for referring an individual to a health care provider for the furnishing of a service payable under a federal health care program. The statute covers the other side of the transaction as well – anyone who knowingly and willfully offers or pays remuneration to induce a person to refer an individual to a health care provider for the furnishing of a service payable under a federal health care program is also guilty of a felony. In plain terms, paying to receive health care referrals or being paid to make health care referrals may result in a wardrobe that is less business casual and more jail-appropriate. Just ask Mary Smettler-Bolton, age 71, of Oakland County, Michigan. Her role in what appears to be a run-of-the-mill kickback scheme, under which the owners and operators of home health companies paid Ms. Smettler-Bolton for referrals, resulted in a federal conviction and a maximum potential penalty of 10 years in prison, according to a DOJ press release.2 Federal regulators take AKS violations seriously, citing the increased cost to federal health care programs caused by kickback THE HEALTH CARE INDUSTRY IS, PERHAPS, THE MOST REGULATED INDUSTRY in the United States. Business practices that are common and acceptable in other industries may be illegal in the health care industry. Lawyers who do not routinely practice health care law and do not stay up to date on the complex web of laws and regulations applicable to health care providers need to be careful not to inadvertently provide incorrect advice in reliance on legal principles of another industry that do not translate to the health care industry. The purpose of this article is to outline examples of situations in which business practices commonly used in other industries may cause real legal issues in the health care industry. Some key health care laws are counterintuitive and esoteric, and what you don’t know may hurt you.
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