205.8461 Unlawful referral practices of provider -- Penalties.

263 words·~1 min read·/ky/chapter-205/205-8461

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

(1)Except as otherwise provided in KRS 205.510 to 205.630, no provider shall

knowingly solicit, receive, or offer any remuneration (including any kickback, bribe,

or rebate) for furnishing medical assistance benefits or in return for purchasing,

leasing, ordering, or arranging for or recommending purchasing, leasing, or ordering

any goods, facility, service, or item for which payment may be made pursuant to

Title XIX of the Social Security Act.

(a)No provider shall knowingly make, offer, or receive a payment, a rebate of a

fee, or a charge for referring a recipient to another provider for furnishing of

benefits.

(b)Any conduct or activity which does not violate or which is protected under the

provisions of 42 U.S.C. sec. 1395nn or 42 U.S.C. sec. 1320A-7b(b), as

amended, or federal regulations promulgated under those statutes, shall not be

deemed to violate the provisions of KRS 205.8451 to 205.8483, and the

conduct or activity shall be accorded the same protections allowed under

federal law and regulation.

(3)Any person who violates subsection

(1)or

(2)of this section shall be guilty of a

Class A misdemeanor unless the combination or aggregation of offenses is valued at

three hundred dollars ($300) or more, in which case it shall be a Class D felony. In

addition to any other penalty authorized by law, any person who violates the

provisions of subsection (2)(a) of this section shall not be entitled to bill or collect

from the recipient or any third-party payor and shall repay any payments due the

Commonwealth for services provided which were related to the referral.