Which of the following are examples of fraudulent kickbacks in the health care industry?

• A. All of the above
• B. Payment for referral of patients
• C. Waiver of deductibles and copayments
• D. Payment for additional medical coverage

Answer: (A)

Fraudulent kickbacks in health care are illegal incentives meant to influence referrals or patient choices by giving something of value. A payment for the referral of patients is the classic form: it creates a financial motive to send patients to a specific provider, which can distort medical judgment and inflate costs. Waiving deductibles and copayments likewise counts, because it directly reduces what a patient pays to steer them toward a particular provider, undermining fair decision-making and often violating anti-kickback rules. Payment for additional medical coverage can also be improper if it’s used to influence which plan a patient chooses or to secure referrals, tying financial gain to patient enrollment or vendor relationships rather than medical need. When these incentives are tied to referrals or patient choices, they reflect fraudulent kickbacks. Therefore, all of the listed practices illustrate fraudulent kickbacks in the health care industry.