Indiana Anti-Kickback & Referral Laws

Indiana Anti-Kickback Law at a Glance

Indiana's anti-kickback and referral laws primarily target the offering or receiving of fees in exchange for referrals that are reimbursable by Medicaid. These laws are designed to prevent conflicts of interest and ensure that healthcare decisions are made in the best interest of patients rather than financial gain. While Indiana does not have a broad statutory prohibition on fee-splitting or kickbacks in the private sector, its laws specifically address Medicaid-reimbursable referrals, aligning with federal anti-kickback and Stark Law principles in certain contexts. This framework influences how healthcare providers and entities structure referral arrangements, particularly where Medicaid is involved.

State Statutes

Ind. Code § 12-15-24-2 criminalizes the offering or receiving of any fee, commission, or other form of remuneration for the purpose of inducing or rewarding a referral of an individual for a service that is reimbursable by the state's Medicaid program. This statute applies to both individuals and entities, and it explicitly prohibits such arrangements regardless of whether the referral is for a service that would otherwise be payable by a federal health care program. The law reflects Indiana's commitment to preventing financial incentives that could distort medical decision-making in the Medicaid context.

In addition to this specific statute, Indiana's broader healthcare regulatory landscape may be influenced by federal anti-kickback and Stark Law provisions, particularly in cases involving federal reimbursement. However, the only state-specific statute directly addressing kickbacks in the context of Medicaid-reimbursable referrals is Ind. Code § 12-15-24-2.

Enforcement

Enforcement of Indiana's anti-kickback and referral laws is typically handled by state licensing boards, including the Indiana State Medical Licensing Board, the Indiana State Dental Licensing Board, and other relevant professional licensing entities. These boards are responsible for investigating allegations of violations and taking disciplinary action when appropriate. Additionally, the Indiana Attorney General's Office may be involved in prosecuting criminal violations under Ind. Code § 12-15-24-2, especially in cases involving Medicaid fraud or abuse.

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

Indiana's state-specific anti-kickback and referral laws interact with federal regimes in a manner that can create overlapping obligations, particularly in the context of Medicaid-reimbursable referrals. For a more detailed analysis of these interactions, refer to the following pages: /practice-areas/, /the-anti-kickback-statute-explained-why-referral-payments-trigger-scrutiny/, /safe-harbors-under-the-anti-kickback-statute-and-where-providers-get-tripped-up/, /aks-and-stark-law-how-the-two-regimes-overlap-in-healthcare-investigations/, /recent-antikickback-statute-decisions/, and /faq/.