Can I give gifts or pay case managers, doctors or hospital staff for referrals?
No, not for Medicaid business. Federal law makes it a crime to offer or pay anything of value to get or reward referrals for services paid by federal health programs, which include Medicaid. Don’t pay per referral or give gifts to referral sources. Ask a health care attorney before any marketing deal.
The federal Anti-Kickback Statute (42 U.S.C. 1320a-7b(b)) makes it a crime to knowingly offer or pay anything of value to get or reward referrals for services paid for by federal health care programs, including Medicaid. A trade guide I read explains the "one purpose" test: if getting referrals is even one purpose of a payment, it can break the law.
What that guide lists as risky:
- Paying a marketer per referral or per client.
- Gifts to referral sources.
- Free services to a facility that refers to you.
- Leases or contracts at above or below market value.
Penalties can include fines, prison, and exclusion from federal programs. Some states have their own versions that cover all payers.
What is usually fine: telling people what you do, bringing information, answering the phone fast, and paying a W-2 employee a normal salary, though pay tied closely to referral volume is flagged as risky. Even so, the details matter.
This is not legal advice. Before you hire a marketer, sign a referral deal, or give anything to a referral source, ask a health care attorney.
Sources
- What the Anti-Kickback Statute actually prohibits in hospice and home health marketing (cites 42 U.S.C. 1320a-7b(b)) · National Directory of Post-Acute Providers (secondary source)
Reviewed by Beth Bledsoe, Care Business Advisor®, 28 Oct 2026. Rules change. Confirm with your state Medicaid agency before you act.
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