EKRA (Eliminating Kickbacks in Recovery Act)
EKRA, the Eliminating Kickbacks in Recovery Act of 2018, is the federal law (18 U.S.C. 220) that makes it a crime to pay or receive kickbacks for referring patients to recovery homes, clinical treatment facilities or laboratories.
Also called Eliminating Kickbacks in Recovery Act, 18 U.S.C. 220
- Last reviewed
- 2 sources, linked
- 4 related terms
What it means
EKRA was enacted on October 24, 2018, as part of the SUPPORT for Patients and Communities Act (Public Law 115-271). It reaches anyone who knowingly and willfully solicits or receives remuneration for referring a patient, and anyone who pays or offers remuneration to induce a referral or in exchange for a person using the facility's services. Remuneration can be direct or indirect, in cash or in kind.
The federal Anti-Kickback Statute is tied to federal health care programs. EKRA applies when the services are covered by any health care benefit program, which federal law defines as any public or private plan or contract, so commercial insurance is included. The penalty is a fine of up to $200,000, up to 10 years in prison, or both, for each occurrence.
There are exceptions, including pay to a genuine employee or contractor that does not vary with the number of people referred, the number of tests or procedures, or the amount billed. Whether a particular marketing contract fits an exception is a question for a healthcare attorney.
Why it matters for your website
The website is where EKRA risk usually shows first: lead vendors, bought calls, offers of free travel or housing, and agency contracts priced per admission. Pay for work, never per referred patient, and keep every inducement off your pages.
Build the inbound channels you own instead: organic search, your Google Business Profile, AI visibility and pages that convert the visitors you already have.
Sources
The facts on this page about a law, a regulator, a clinical standard or a platform come from these sources. Each link opens the original in a new tab.
- Cornell Law School, Legal Information Institute18 U.S. Code § 220, Illegal remunerations for referrals to recovery homes, clinical treatment facilities, and laboratories (opens in a new tab)
- Cornell Law School, Legal Information Institute18 U.S. Code § 24, Definitions relating to Federal health care offense (opens in a new tab)
Last reviewed
This entry explains a rule so you can plan a website around it. It is not legal advice: for a decision about your own program, ask a healthcare attorney.
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