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Orlando Criminal Defense Lawyer > Blog > Criminal > Is It Illegal for the Healthcare Provider to Pay for Referrals in Florida?

Is It Illegal for the Healthcare Provider to Pay for Referrals in Florida?

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Many white collar crimes in Florida center on the healthcare industry. For example, Section 817.505 of the Florida Statutes makes it unlawful for anyone, including a healthcare provider or facility, to pay any sort of “benefit, bonus, rebate, kickback, or bribe” in exchange for a patient referral. A violation of this section is a third-degree felony in Florida, and it may be elevated as high as a first-degree felony if 20 or more patients are involved.

Florida Appeals Court Reinstates Additional Charges Against Lab Owner Accused of Paying Kickbacks

A recent decision from the Florida Fourth District Court of Appeal, State v. DeSimone, illustrates just how seriously Florida prosecutors take these sort of cases. This particular case involves a defendant associated with a laboratory that performs drug testing of urine samples. One of the laboratory’s regular clients was a substance abuse treatment facility.

According to prosecutors, the defendant and another individual participated in an illegal scheme to bring patients from the treatment facility to the laboratory. The other individual allegedly reached an agreement in 2016 with a different lab to perform testing for the treatment facility in exchange for a percentage of the insurance reimbursements. The defendant advised the other individual that he was opening up a lab in Florida. The defendant then allegedly agreed to a similar pay-for-referral scheme with the other individual.

The defendant was charged with nine violations of § 817.505, four for payments made to a business entity controlled by the treatment facility, and five for payments to two entities controlled by the other individual. The trial court dismissed the first four counts as duplicative, leaving just the five counts regarding the defendant’s alleged referral payments to the other individual.

On the state’s appeal, however, the Fourth District reinstated the other five charges. The essential question was whether the alleged payments made to different legal entities for referral of the same group of patients could constitute separate violations of § 817.505. The Fourth District said each payment could be separately charged, since the “correct unit of prosecution” was each payment “made to induce the referral of patients or patronage.”

Put another way, even though there was allegedly a single scheme to make illegal payments for the referral of a group of patients, prosecutors charged the defendant with paying each entity separately to induce the referral. As such, the state could plausibly charge the defendant with a separate offense for each payment. The focus of the statute was on the person making the payments, the Fourth District noted, rather than the person receiving the payments.

Contact the Joshi Law Firm Today

As you can see, the potential criminal charges can add up quickly in a fraud case. This is what makes white collar criminal prosecutions potentially more serious than many cases involving allegations of violent crimes. So if you are facing criminal prosecution for fraud or a similar offense, it is important to work with an experienced Orlando criminal defense attorney who can zealously represent your interests. Contact the Joshi law Firm, P.A., today to schedule a free consultation.

Sources:

flsenate.gov/Laws/Statutes/2023/0817.505

4dca.flcourts.gov/content/download/1166466/opinion/Opinion_2022-2104.pdf

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