Hawaii Anti-Kickback & Referral Laws

Hawaii Anti-Kickback Law at a Glance

Hawaii’s anti-kickback and referral laws primarily focus on prohibiting fee-splitting arrangements and financial interests that may influence the referral of healthcare services. These rules are especially relevant in healthcare settings where professionals or entities may have an economic stake in the outcome of referrals. The state’s approach aligns with broader federal anti-kickback and Stark Law frameworks, but applies independently in cases involving non-federal healthcare programs. The emphasis is on ensuring that referral practices do not compromise the integrity of patient care or the fairness of healthcare delivery.

State Statutes

Haw. Rev. Stat. § 431:10C-308.7(b) prohibits the splitting of fees for referrals or the receipt of a financial interest in the referral of healthcare services. This applies to licensed healthcare professionals and entities that engage in such practices. It is a key provision in Hawaii’s regulatory scheme aimed at preventing conflicts of interest in referral arrangements.

Haw. Rev. Stat. § 431:10C-308.7(c) provides for the revocation of licenses for individuals or entities that engage in prohibited fee-splitting or referral-based financial arrangements. This reinforces the legal consequences of violating these rules and underscores the state’s commitment to maintaining ethical standards in healthcare.

Enforcement

Enforcement of Hawaii’s anti-kickback and referral laws falls under the jurisdiction of state licensing boards and regulatory agencies, including the Hawaii Department of Commerce and Consumer Affairs and the Hawaii Medical Board. These entities are responsible for investigating complaints, conducting audits, and taking disciplinary actions such as license revocation or suspension when violations are confirmed.

The Federal Overlay

The federal Anti-Kickback Statute, 42 U.S.C. § 1320a-7b(b), makes it a felony to knowingly and willfully offer, pay, solicit, or receive remuneration to induce or reward referrals of items or services payable by a federal health care program. The Stark Law, 42 U.S.C. § 1395nn, separately prohibits physician self-referrals for designated health services payable by Medicare or Medicaid, on strict-liability terms. Both regimes carry safe harbors and exceptions published at 42 C.F.R. § 1001.952. State referral and fee-splitting statutes operate alongside these federal prohibitions and can apply even where no federal program payment is involved.

Reading the State Desk

Hawaii’s anti-kickback and referral laws interact with federal regimes, creating a layered regulatory environment. For further exploration, visit /practice-areas/ for an overview of research topics, /the-anti-kickback-statute-explained-why-referral-payments-trigger-scrutiny/ for an explanation of the Anti-Kickback Statute, /safe-harbors-under-the-anti-kickback-statute-and-where-providers-get-tripped-up/ for safe harbor analysis, /aks-and-stark-law-how-the-two-regimes-overlap-in-healthcare-investigations/ for insights on AKS and Stark Law overlap, /recent-antikickback-statute-decisions/ for recent developments, and /faq/ for frequently asked questions.