Washington Anti-Kickback & Referral Laws

Washington Anti-Kickback Law at a Glance

Washington state law imposes restrictions on fee-splitting and referral arrangements in healthcare through statutory prohibitions on rebating or paying for referrals. These laws are designed to prevent conflicts of interest and ensure that medical decisions are made in the best interest of patients rather than for financial gain. While Washington does not have a comprehensive statute mirroring the federal Anti-Kickback Statute or Stark Law, its rules on rebating and referral payments shape the legal landscape for healthcare providers, particularly in arrangements involving referrals between professionals or entities.

State Statutes

Wash. Rev. Code § 19.68.010 prohibits a person from receiving or agreeing to receive any money, property, or other thing of value for referring a patient or client to another person or entity for the purpose of obtaining services, goods, or other things of value. This statute applies broadly and is enforceable by state licensing boards or other regulatory authorities. It is considered a misdemeanor and may also result in unprofessional conduct charges for licensed professionals. The statute does not distinguish between public and private healthcare settings, making it applicable in both contexts.

While this statute does not explicitly reference federal programs or Medicare/Medicaid, its enforcement can intersect with federal anti-kickback and Stark Law enforcement, particularly in cases involving referrals that also implicate federal payment sources. However, the statute stands independently and can apply even in the absence of federal program involvement.

Enforcement

Enforcement of Washington's referral and fee-splitting laws is typically handled by state licensing boards, such as the Washington State Medical Commission, the Washington State Dental Quality Assurance Commission, and other professional licensing authorities. These boards have the authority to investigate complaints, impose disciplinary actions, and ensure compliance with professional conduct standards. In some cases, the Washington State Attorney General’s Office may also be involved in prosecuting violations of Wash. Rev. Code § 19.68.010, particularly when the conduct involves broader public interest concerns.

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 better understand how Washington's laws interact with federal anti-kickback and referral regulations, explore related topics on /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/.