Which scenario is a violation of the Anti-Kickback Statute?

• A. A physician bills for services that were not provided.
• B. A drug representative pays a provider cash for every sale.
• C. A hospital accepts donated equipment.
• D. A patient signs a waiver.

Answer: (B)

The Anti-Kickback Statute forbids giving or taking any payment to induce referrals or prescriptions for items or services that are reimbursed by federal health programs. The scenario where a drug representative pays a provider cash for every sale is a textbook kickback: the cash is a direct incentive tied to increasing referrals or prescriptions, which the statute prohibits regardless of the amount.

Other options don’t show the same referral-based inducement. Billing for services not provided is a false claims issue—fraudulently claiming payment for non-existent services—rather than a kickback to influence referrals. Donated equipment can be legitimate if it isn’t conditioned on referrals or purchases, and there are exceptions in practice for charitable contributions. A patient signing a waiver relates to consent or liability, not to improper financial incentives to influence referrals.

So the case with cash payments to a provider for each sale best illustrates a violation of the Anti-Kickback Statute.