Nebraska Anti-Kickback & Referral Laws

Nebraska Anti-Kickback Law at a Glance

Nebraska’s anti-kickback and referral laws primarily address the issue of commercial bribery, particularly in contexts where individuals breach a duty of disinterest. The state does not have specific statutes governing fee-splitting or referral arrangements in healthcare, but its laws on commercial bribery may apply to certain types of improper financial incentives. These provisions are distinct from federal anti-kickback and Stark Law requirements, which also govern healthcare arrangements. As a result, healthcare providers and entities in Nebraska must consider both state and federal regimes when structuring referral and compensation arrangements.

State Statutes

Neb. Rev. Stat. § 28-613 addresses commercial bribery by prohibiting any person from receiving a benefit in exchange for breaching a duty of disinterest. This statute is broad and may apply to situations where a healthcare provider receives a financial incentive in exchange for referring patients or services to another entity. While not specifically tailored to healthcare, it could intersect with referral arrangements that involve improper financial benefits. The statute does not contain exceptions for certain types of payments or arrangements, and its application depends on whether a duty of disinterest was breached and whether a benefit was received as a result.

Unlike some other states, Nebraska does not have a specific statute that prohibits fee-splitting or imposes restrictions on referral arrangements in the healthcare sector. As a result, the only relevant state law governing potential kickback-like arrangements is Neb. Rev. Stat. § 28-613, which applies to commercial bribery in general. This means that healthcare providers must be particularly cautious in ensuring that any financial incentives or referral arrangements do not trigger liability under this broad prohibition.

Enforcement

Enforcement of Nebraska’s anti-kickback and referral laws is typically handled by state licensing boards and regulatory agencies. For example, the Nebraska Department of Health and Human Services may investigate allegations of commercial bribery in healthcare settings. In addition, professional licensing boards for physicians, nurses, and other healthcare providers may take disciplinary action against individuals found to have violated Neb. Rev. Stat. § 28-613. These agencies are responsible for ensuring that individuals and entities comply with the state’s legal standards regarding conflicts of interest and improper financial incentives.

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

Nebraska’s anti-kickback and referral laws interact with federal regimes in a way that may create additional compliance considerations. For further analysis, see /practice-areas/ for an overview of key research topics, /the-anti-kickback-statute-explained-why-referral-payments-trigger-scrutiny/ for a detailed explanation of the federal Anti-Kickback Statute, /safe-harbors-under-the-anti-kickback-statute-and-where-providers-get-tripped-up/ for an overview of safe harbors, /aks-and-stark-law-how-the-two-regimes-overlap-in-healthcare-investigations/ for an analysis of the overlap between the Anti-Kickback Statute and Stark Law, /recent-antikickback-statute-decisions/ for recent developments, and /faq/ for commonly asked questions.