Maryland Anti-Kickback & Referral Laws

Maryland Anti-Kickback Law at a Glance

Maryland's anti-kickback and referral laws are shaped by both state-specific statutes and federal frameworks. The state explicitly criminalizes bribes or kickbacks for referrals related to state health plans, which is particularly relevant for healthcare providers involved in arrangements with state-funded programs. While Maryland does not have explicit statutory prohibitions on fee-splitting in the same way some other states do, the presence of federal anti-kickback and Stark Law provisions influences the legal landscape. These laws interact with state licensing and regulatory bodies to enforce compliance in healthcare transactions.

State Statutes

Md. Code, Crim. Law § 8-511 criminalizes the offering, paying, soliciting, or receiving of any bribe or kickback for the purpose of influencing a referral of items or services payable by a state health plan. This statute applies to any individual or entity involved in the referral process, including healthcare providers, hospitals, and other stakeholders. The law is designed to prevent corruption and ensure that healthcare decisions are made in the best interest of patients rather than for financial gain.

Although Maryland does not have a specific statute on fee-splitting, the federal Anti-Kickback Statute and Stark Law have broad applicability and can be used to address improper financial arrangements, even if they involve state rather than federal health programs. These federal provisions often serve as a complement to the state statute in cases involving complex or multi-jurisdictional arrangements.

Enforcement

Enforcement of Maryland's anti-kickback and referral laws is primarily handled by state licensing boards and regulatory agencies, including the Maryland Board of Physicians, the Maryland Board of Nursing, and the Maryland Health Care Commission. These entities are responsible for investigating and taking disciplinary action against individuals or organizations that violate referral and anti-kickback laws. In addition, state prosecutors may bring criminal charges under Md. Code, Crim. Law § 8-511 in cases involving criminal violations.

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

Understanding how Maryland's anti-kickback and referral laws interact with federal regulations is essential for healthcare professionals and legal counsel. For further analysis, see /practice-areas/ for 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 AKS/Stark overlap insights, /recent-antikickback-statute-decisions/ for recent cases, and /faq/ for common questions.