Anti-Kickback Statute Overview (42 USC 1320a-7b(b))
Criminal prohibition on knowingly and willfully soliciting, receiving, offering, or paying remuneration to induce or reward federal health care program business, with safe harbors at 42 CFR 1001.952.
Primary source
42 USC 1320a-7b(b) — Office of the Law Revision Counsel →https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1320a-7b&num=0&edition=prelim
Verified May 23, 2026 · This is the authoritative regulator URL. The summary below is a research aid; the linked source controls.
Additional sources
42 USC 1320a-7b(b) — the Anti-Kickback Statute (AKS) — makes it a federal crime to knowingly and willfully solicit, receive, offer, or pay any remuneration (directly or indirectly, in cash or in kind) to induce or reward referrals of items or services payable by any federal health care program (Medicare, Medicaid, TRICARE, VA, Indian Health Service).
Penalties: criminal — fines up to $100,000 per violation, imprisonment up to 10 years, or both; civil — exclusion from federal health care programs, CMPs up to $100,000 per violation plus three times the remuneration. The Affordable Care Act clarified that AKS violations also create False Claims Act liability — any claim "resulting from" an AKS violation is a false claim.
The statute is intent-based — requires "knowingly and willfully." Courts apply the "one purpose" rule: if even one purpose of the remuneration is to induce referrals, the statute is violated, even if other legitimate purposes exist.
Safe harbors at 42 CFR 1001.952 protect specific arrangements that meet all conditions. Failure to fit a safe harbor is not a per se violation, but exposes the arrangement to fact-specific scrutiny.
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Related across the archive
- RegulationAKS Personal Services and Management Contracts Safe Harbor (42 CFR 1001.952(d))Safe harbor for compensation to an independent contractor for personal services, with seven conditions including written agreement, fair market value, and aggregate compensation set in advance.
- RegulationAnti-Kickback Safe Harbors Overview (42 CFR 1001.952)Approximately 30 safe harbors define payment and business practices that, despite generating remuneration, do not result in AKS liability when all conditions are met.
- RegulationStark Law Overview (42 USC 1395nn)Strict-liability prohibition on physician referrals to entities for designated health services payable by Medicare when the physician (or immediate family member) has a financial relationship with the entity, unless an exception applies.
- ComplianceAnti-Kickback Statute: What Medical Practices Actually Need to Know (42 USC § 1320a-7b(b))The federal Anti-Kickback Statute is intent-based, criminal-grade, and the most common fraud-and-abuse theory in OIG enforcement. Here is what AKS actually prohibits, how the safe harbors function, and where practices get caught.
- RegulationAKS Space Rental Safe Harbor (42 CFR 1001.952(b))Safe harbor for rental payments for office space when six conditions are met, including written lease, at least one-year term, and aggregate rent set in advance at fair market value.
- RegulationAKS Value-Based Arrangement Safe Harbors (42 CFR 1001.952(ee)-(gg))Three safe harbors added in the 2020 Sprint to Coordinated Care final rule covering value-based arrangements at varying risk levels: care coordination, substantial downside risk, and full financial risk.
- SRAHIPAA Settlements and Civil Money Penalties: A Small-Practice Reading ListHow HHS Office for Civil Rights publishes its enforcement record, the tiered civil money penalty structure at 45 CFR 160.404, and what recent small-practice settlements actually say.
- GlossaryAnti-Kickback Statute (AKS)Federal criminal statute (42 USC 1320a-7b(b)) that prohibits offering, paying, soliciting, or receiving remuneration to induce or reward referrals for items or services payable by federal health programs.
Last reviewed May 23, 2026 · Citation verified May 23, 2026
Research aid, not legal advice. This summary is an administrative research aid prepared by D3rx. It does not certify compliance, provide legal advice, replace counsel, or guarantee an audit outcome. For authoritative regulatory text follow the primary source link at the top of this page. The practice remains responsible for reviewing, adopting, and maintaining its compliance program.