New Jersey Anti-Kickback & Referral Laws

New Jersey Anti-Kickback Law at a Glance

New Jersey's anti-kickback and referral laws play a significant role in regulating healthcare arrangements, particularly in the context of fee-splitting and physician referrals. The state prohibits certain types of remuneration that could influence medical decisions, especially when they involve a breach of a duty of fidelity. While New Jersey does not have a comprehensive statute mirroring the federal Stark Law or Anti-Kickback Statute, its laws interact with federal regimes to address potential conflicts of interest in healthcare transactions.

State Statutes

N.J. Stat. § 2C:21-10(a)(3) addresses commercial bribery and specifically applies to situations where a physician breaches a duty of fidelity by receiving a benefit in exchange for referrals. This statute criminalizes the act of a physician accepting any form of remuneration, whether direct or indirect, that influences their professional judgment in referring patients for medical services. The law applies broadly to any arrangement where a physician's professional conduct is compromised for personal gain, regardless of whether the referral involves a federal health care program.

In addition to this statute, New Jersey's anti-kickback framework is informed by federal laws, which provide a broader context for interpreting and enforcing similar conduct. While the state's laws may not be as detailed as federal equivalents, they serve as an important layer of regulation that can intersect with federal enforcement actions in cases involving healthcare referrals and remuneration.

Enforcement

Enforcement of New Jersey's anti-kickback and referral laws is primarily carried out by state licensing boards and regulatory agencies, including the New Jersey Medical Board, the New Jersey Board of Nursing, and the New Jersey Department of Health. These entities are responsible for investigating complaints, conducting audits, and taking disciplinary action against professionals who violate the state's laws. In cases involving criminal conduct, such as those under N.J. Stat. § 2C:21-10(a)(3), the New Jersey Division of Criminal Justice may also be involved.

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 further understand how New Jersey's laws interact with federal anti-kickback and referral regimes, 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/.