Georgia’s new anti-kickback statute relating to drug abuse treatment and education programs took effect on July 1, 2021. The new statute comes as many states adopt similar laws that reflect the Federal Eliminating Kickbacks in Recovery Act of 2018 in an effort to fight patient brokering and abusive practices in substance abuse recovery programs.
Georgia’s new statute prohibits substance abuse treatment providers from engaging in patient brokering and includes limited exceptions and provisions for enforcement and penalties. Specifically, the statute prohibits:
- Payment of, or offers to pay remuneration to induce the referral of a patient or patronage to or from a substance abuse provider;
- Solicitation of, or receipt of remuneration in return for the referral of a patient or patronage to or from a substance abuse provider;
- Solicitation of or receipt of remuneration, or engagement in any split-fee arrangement in return for the acceptance or acknowledgement of treatment from a substance abuse provider; or
- Aiding, abetting, advising, or otherwise participating in the conduct outlined in points 1-3 above.
Georgia’s new anti-kickback statute provides for limited exceptions, including (i) certain payments that are not prohibited by the Federal Anti-Kickback Statute (42 U.S.C. Section 1320a-7b(b)); (ii) certain arrangements among members of the same group practice; (iii) payments to healthcare providers for professional services; (iv) commissions lawfully paid to insurance agents; (v) payments to health insurers that cover health, mental health or substance abuse services under a health benefit plan; (vi) certain arrangements between healthcare providers and health insurers/health purchasing groups, or the Medicare or Medicaid programs; (vii) certain insurance advertising gifts (as permitted under OCGA 33-6-4); and (viii) certain payments by substance abuse providers to substance abuse information sources that provide information on request and without charge to consumers about healthcare providers, to help consumers select appropriate healthcare providers.
- This new statute applies to patients with both governmental insurance coverage and commercial insurance coverage.
- Violations can result in criminal liability, including imprisonment.
- The new statute also prohibits excessive testing, fraudulent testing, or “high-tech drug testing” in the treatment of the elderly, the disabled, or any individual affected by pain, substance abuse, addiction, or any related disorder.
- Georgia’s broader patient referral prohibitions under OCGA Title 43 remain in place and still prohibit patient self-referrals for certain licensed providers, like physicians and pharmacists. However, note that this new anti-kickback statute is applicable to “any person.”
The attorneys at Chilivis Grubman represent clients of all types and sizes in connection with healthcare regulatory and compliance matters under both federal law and state law. If you need assistance with such a matter, please contact us today.