BC Advantage - 2023 Issue 3
The Eliminating Kickbacks in Recovery Act Legality of Percentage-Based Compensation
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Article Overview
This article explains the Eliminating Kickbacks in Recovery Act (EKRA), why it was enacted, and how its broad anti-kickback framework compares with the federal AKS. It summarizes limited case law interpreting percentage-based compensation for marketers and sales personnel, with emphasis on laboratory and recovery-related arrangements, and is aimed at compliance, legal, and healthcare reimbursement audiences.
Why This Topic Matters
EKRA can affect compensation structures, referral relationships, and compliance practices for laboratories and related healthcare providers. Understanding the article helps organizations evaluate risk in light of limited guidance and evolving court interpretation.
Article Sections
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EKRA overview and relationship to SUPPORT and AKS
Introduces EKRA, its legislative context, and its relationship to other healthcare fraud and abuse concepts. Describes the general compliance framework and the limited nature of available guidance.
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Case Law
Summarizes the small body of case law addressing compensation practices and referral-related conduct under EKRA. Focuses on how courts have treated employer compensation arrangements and related marketing activity.
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Conclusion
Provides a brief closing discussion about the practical compliance concerns raised by limited guidance. Highlights the importance of caution when structuring compensation methodologies for affected provider types.
What You Will Learn
- The general purpose and scope of EKRA
- How EKRA is positioned relative to the AKS
- What the article says about limited judicial guidance
- The kinds of compensation arrangements discussed in the case law
- Why laboratories and related providers may review compensation practices carefully
Who Should Read This
- Compliance professionals
- Healthcare attorneys
- Laboratory administrators
- Medical practice managers
- Revenue cycle and auditing professionals
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