South Carolina Anti-Kickback & Referral Laws

South Carolina Anti-Kickback Law at a Glance

South Carolina’s anti-kickback and referral laws are primarily governed by S.C. Code § 44-113-60, which criminalizes offering, paying, soliciting, or receiving referral remuneration. These laws shape healthcare arrangements by prohibiting any form of remuneration intended to influence referrals of healthcare services. While South Carolina does not have specific fee-splitting statutes, the state’s referral laws align with broader anti-kickback principles. These rules apply to a wide range of healthcare providers and entities, and they are often enforced in conjunction with federal anti-kickback and Stark Law provisions.

State Statutes

S.C. Code § 44-113-60 prohibits the offering, paying, soliciting, or receiving of any remuneration in exchange for the referral of patients or the recommendation of healthcare services. This includes both direct and indirect payments, and the law applies to any individual or entity involved in the referral process. The statute does not distinguish between public and private healthcare programs, meaning that its scope extends beyond federal healthcare programs. Violations of this statute can result in criminal penalties, including fines and imprisonment, depending on the nature and severity of the offense.

While South Carolina does not have specific statutes addressing fee-splitting arrangements, the state’s referral laws and the federal Anti-Kickback Statute may apply to such arrangements if they involve remuneration for referrals. This means that healthcare providers and entities must be cautious when structuring any financial arrangements involving referrals, as both state and federal laws may be triggered.

Enforcement

Enforcement of South Carolina’s anti-kickback and referral laws is primarily handled by state licensing boards and regulatory agencies, including the South Carolina Department of Health and Human Services and the South Carolina Medical Board. These entities have the authority to investigate complaints, conduct audits, and impose disciplinary actions such as fines, license revocation, or other sanctions against violators. In cases involving criminal violations, the South Carolina Attorney General may also become involved, potentially leading to criminal charges under state law.

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

South Carolina’s anti-kickback laws interact with federal regimes in complex ways, requiring careful analysis of both state and federal statutes. For further exploration of these issues, refer to /practice-areas/ for an overview of research topics, /the-anti-kickback-statute-explained-why-referral-payments-trigger-scrutiny/ for a detailed explanation of the Anti-Kickback Statute, /safe-harbors-under-the-anti-kickback-statute-and-where-providers-get-tripped-up/ for an analysis of safe harbors, /aks-and-stark-law-how-the-two-regimes-overlap-in-healthcare-investigations/ for an examination of AKS and Stark Law overlap, /recent-antikickback-statute-decisions/ for recent case law, and /faq/ for frequently asked questions.