News & Analysis as of

Eliminating Kickbacks in Recovery Act of 2018 (EKRA)

Sheppard Mullin Richter & Hampton LLP

Inside the Ninth Circuit’s Interpretation of EKRA: Clarity for Kickback Law

On July 11, 2025, in United States v. Schena,[1] the Ninth Circuit adopted an expansive interpretation of the Eliminating Kickbacks in Recovery Act (EKRA), applying the law to any payment that could have the effect of...more

Epstein Becker & Green

Ninth Circuit Applies EKRA to Marketing Intermediaries in Lab Operator’s Allergy Testing Scheme

Epstein Becker & Green on

The U.S. Court of Appeals for the Ninth Circuit has held that a laboratory owner’s payments to marketing intermediaries violated the Eliminating Kickbacks in Recovery Act (EKRA)—in its first interpretation of the statute...more

Buchalter

9th Circ. Decisions Help Clarify Scope Of Legal Lab Marketing

Buchalter on

The Eliminating Kickbacks in Recovery Act, enacted in 2018, was a bombshell for the addiction treatment and diagnostic laboratory industries. For the first time, paying commissions for sales and marketing services was...more

BakerHostetler

In Case of First Impression, Looking to AKS Precedent, Ninth Circuit Affirms EKRA Conviction for Improper Payments to Marketers

BakerHostetler on

In one of the few prosecutions based on the Eliminating Kickbacks in Recovery Act (EKRA), and in an even rarer Court of Appeals opinion interpreting the statute, the Ninth Circuit in United States v. Schena, No. 23-2989, 2025...more

Mintz - Health Care Viewpoints

Ninth Circuit Court of Appeals Affirms EKRA Conviction for Lab Operator and Provides Insight into Key Provisions

On July 11, 2025, the Ninth Circuit Court of Appeals affirmed the criminal conviction of laboratory operator Mark Schena for violations of the Eliminating Kickbacks in Recovery Act, 18 U.S.C. § 220 (EKRA) based on...more

Maynard Nexsen

Insights from a Recent Court Decision

Maynard Nexsen on

The Eliminating Kickbacks in Recovery Act (EKRA), 18 U.S.C. § 220, is a criminal statute that prohibits knowingly and willfully soliciting or receiving remuneration for referring patients to recovery homes, clinical treatment...more

Epstein Becker & Green

The Department of Justice’s COVID-19 Enforcement Task Force 2024 Report: A Continued Commitment to Combatting COVID-19-Related...

Since the pandemic, COVID-19-related fraud has been a consistent target of the Department of Justice....more

Holland & Hart LLP

Patient Inducements: Law and Limits

Holland & Hart LLP on

Although often well-intentioned, offering free or discounted items or services to patients (e.g., gifts, rewards, writing off copays, free screening exams, free supplies, etc.) may violate federal and state laws governing...more

Holland & Knight LLP

No Sunset on the Horizon for EKRA

Holland & Knight LLP on

Recently, Holland & Knight healthcare attorneys have received questions as to whether the Eliminating Kickback in Recovery Act (EKRA) is still in effect, given the recent expiration of many provisions of the Substance...more

Health Care Compliance Association (HCCA)

[Event] 2023 Healthcare Enforcement Compliance Conference - November 5th - 7th, Washington, DC

Hear directly from the enforcement community - Want to gain insight into properly monitoring, detecting, investigating, and managing violations? Join us at HCCA’s Annual Healthcare Enforcement Compliance Conference to...more

BCLP

Five years on: EKRA's legacy

BCLP on

Five years ago Congress enacted the Eliminating Kickbacks in Recovery Act of 2018 (“EKRA”). Aimed at combating kickbacks in the addiction treatment industry, EKRA prohibits remunerations in return for patient referrals to...more

Polsinelli

DOJ Continues to Target Lab Sales Arrangements and Ordering Practices

Polsinelli on

Signaling its continued scrutiny of the laboratory industry, the Department of Justice (DOJ) entered into a settlement agreement with Texas lab Genotox Laboratories Ltd. last month related to compensation Genotox paid to...more

Troutman Pepper Locke

Eliminating Kickbacks in Recovery Act: What In-Office Laboratories Need to Know

Troutman Pepper Locke on

To combat the effects of declining reimbursement levels, many physicians and practice groups offer ancillary services to improve patient care and supplement practice revenues. The delivery of these ancillary services, such as...more

Holland & Hart LLP

Physicians and Other Healthcare Providers: Beware "Eat What You Kill" Compensation Models

Holland & Hart LLP on

Physicians and other healthcare providers often structure their group compensation formulas on an “eat what you kill” basis, i.e., a provider is paid based on the services he or she performs in addition to items or services...more

K&L Gates LLP

Recent Government Focus on Laboratory Testing and the Impact of EKRA—Where are We in 2023?

K&L Gates LLP on

The Eliminating Kickbacks in Recovery Act (EKRA) was enacted by Congress in October of 2018 as part of the SUPPORT Act. While its initial focus was to address patient brokering and kickback schemes within recovery homes and...more

McDermott Will & Emery

[Event] +Dx Forum 2023 - March 3rd, Washington, DC

+Dx Forum 2023 is the premier gathering for the laboratory diagnostics community. Join us for insightful discussion about the latest regulatory and reimbursement developments....more

Nelson Mullins Riley & Scarborough LLP

Compliance and Regulatory Enforcement Update for Labs

Whether you operated a traditional diagnostic lab, a toxicology lab, or one that performs high-complexity genetic and genomic testing, there were plenty of regulatory nightmares to keep you up at night in 2022. It seems “the...more

Hendershot Cowart P.C.

EKRA and COVID Testing: What Are the Consequences of Violating Federal Kickback Laws?

Hendershot Cowart P.C. on

Despite some regulatory flexibilities granted to clinical laboratories during the COVID-19 crisis, there are two separate federal anti-kickback laws labs must strictly adhere to throughout this public health emergency and...more

Nelson Mullins Riley & Scarborough LLP

Comparison of Three Federal Fraud and Abuse Laws

In the post-COVID era, health care fraud and abuse issues will be aggressively and swiftly enforced by the government. The legal framework and regulations in the health care space can be intimidating. Below is a comparison of...more

Epstein Becker & Green

Four Years After Enactment – Clinical Laboratories Should Not Forget About EKRA

Epstein Becker & Green on

It has been four years since Congress enacted the Eliminating Kickbacks in Recovery Act (“EKRA”), codified at 18 U.S.C. § 220. EKRA initially targeted patient brokering and kickback schemes within the addiction treatment and...more

Epstein Becker & Green

Four Years After EKRA: Reminders for Clinical Laboratories

Epstein Becker & Green on

It has been four years since Congress enacted the Eliminating Kickbacks in Recovery Act (“EKRA”), codified at 18 U.S.C. § 220. EKRA initially targeted patient brokering and kickback schemes within the addiction treatment and...more

Robinson+Cole Health Law Diagnosis

A COVID-19 Laboratory Testing Conviction under EKRA

Mark Schena, the President of Arrayit Corporation, has been found guilty by a jury for violations of the Eliminating Kickbacks in Recovery Act (EKRA), healthcare fraud, wire fraud, and securities fraud....more

Sheppard Mullin Richter & Hampton LLP

California District Court Finds that EKRA Applies to Compensation Methodologies for Labs’ Employed Marketers Who Market to...

Since its passage in late 2018, the Eliminating Kickbacks in Recovery Act (EKRA) (18 U.S.C. § 220) has posed interpretive challenges. Our detailed critical analysis of EKRA is available here...more

Holland & Knight LLP

The State of EKRA: Summer 2022

Holland & Knight LLP on

Enacted in 2018, the Eliminating Kickbacks Recovery Act (EKRA) remains a source of anxiety and confusion in the clinical laboratory industry. In the four years since EKRA's enactment, U.S. Department of Justice (DOJ)...more

Maynard Nexsen

Eliminating Kickbacks in Recovery Act (EKRA) Updates

Maynard Nexsen on

On October 24, 2018, Congress enacted the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act, (the “SUPPORT Act”). Section 1822 of the SUPPORT Act contains the...more

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