The Missouri Medicaid Audit and Compliance Unit (MMAC) wishes to remind providers about incentives that are “kick-backs” and therefore not allowed.
The federal Anti-Kickback Statute is a criminal law that prohibits health care providers in a federal health care program from offering to exchange, or actually exchanging, anything of value to reward someone for referring business. Medicaid is a state and federally funded program. Conviction for a single violation can result in a fine of up to $25,000 and imprisonment. With or without a conviction, individuals may still be excluded from federal health care programs.
Missouri state regulation also prohibits these types of incentives. It is a violation to make any payment to any person for referring someone for goods or services, when MO HealthNet is providing payment. MMAC has received notice of providers offering incentives to MO HealthNet participants, and also offering incentives to employees to induce or refer participants. Providers may face sanctions for these practices.
Please contact MMAC at MMAC.ReportFraud@dss.mo.gov with any questions.