Louisiana Anti-Kickback & Referral Laws

Louisiana Anti-Kickback Law at a Glance

Louisiana’s anti-kickback and referral laws are designed to prevent fraudulent and corrupt practices in the healthcare sector, particularly concerning state health programs. The state explicitly prohibits the payment or receipt of remuneration in exchange for referrals of services or items payable by state health programs. These rules apply broadly to healthcare providers, insurers, and others involved in the referral process. Louisiana’s approach aligns with federal anti-kickback and Stark Law frameworks but extends protections to state-level programs, creating a layered regulatory environment that impacts both public and private healthcare arrangements.

State Statutes

La. Rev. Stat. § 14:70.5(1) criminalizes the act of paying or receiving remuneration for the purpose of inducing or rewarding referrals of items or services payable by a state health program. This provision is a felony offense and applies to any individual or entity engaged in such conduct, regardless of whether the referral is for a federal or state program. The statute reflects Louisiana’s commitment to preventing conflicts of interest and ensuring that healthcare decisions are made in the best interests of patients rather than financial incentives.

In addition to this criminal provision, Louisiana’s legal framework is influenced by the broader federal anti-kickback and Stark Law regimes, which provide additional context and enforcement mechanisms. While the state statute focuses specifically on state health programs, it operates in conjunction with federal laws that govern referrals involving Medicare, Medicaid, and other federal healthcare programs.

Enforcement

Enforcement of Louisiana’s anti-kickback and referral laws is primarily the responsibility of state licensing boards and regulatory agencies, including the Louisiana State Board of Medical Examiners, the Louisiana State Board of Dentistry, and the Louisiana Office of Public Health. These entities have the authority to investigate allegations of illegal remuneration for referrals, impose disciplinary actions, and refer cases to law enforcement for criminal prosecution when warranted.

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

To fully understand how Louisiana’s anti-kickback laws interact with federal regimes, consider exploring related topics such as the Anti-Kickback Statute’s legal framework, safe harbors, and how referral laws intersect with Stark Law. Further reading is available at /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/.