When a Referral Becomes a Crime: Patient Brokering and RICO Risk for Florida Healthcare Businesses
A marketing company brings your practice a steady stream of new patients, and you pay them a fee for it. Simple business arrangement, right? Not necessarily. In Florida healthcare, how you pay for referrals can be the difference between a normal marketing contract and a criminal case with civil RICO exposure attached.
The Patient Brokering Act, in Plain Terms
Florida’s Patient Brokering Act, codified at Fla. Stat. § 817.505, makes it unlawful for any person or entity, including healthcare providers and facilities, to offer, pay, solicit, or receive a commission, bonus, rebate, kickback, or bribe, or to engage in a split-fee arrangement, in exchange for referring patients. The statute grew out of scandals involving so-called “patient brokers” who screened people at recovery meetings and shelters for insurance coverage and then sold those referrals to treatment facilities.
The statute applies broadly. It is not limited to obvious cash bribes. Marketing agreements, per-patient fees, and referral bonuses can all trigger scrutiny if the payment is tied to the volume or value of referrals rather than to a legitimate, fixed service.
Why RICO Makes This Worse
A single patient brokering violation is serious enough on its own, carrying felony penalties depending on the number of patients involved. But when brokering allegations involve a pattern of conduct across multiple transactions, prosecutors and private plaintiffs increasingly look to civil RICO theories, both state and federal, to reach individual owners, referring physicians, and marketing partners, not just the entity that signed the contract.
That combination changes the stakes considerably:
- Alleged violations can support both criminal charges and civil RICO claims
- Civil RICO allows plaintiffs to seek treble damages and attorney’s fees
- Liability can extend to owners and executives personally, not just the business
- Insurance and licensing consequences often follow close behind any allegation
Where Facilities Run Into Trouble
The riskiest arrangements tend to involve percentage-based marketing fees, payments to individuals who have informal relationships with patients rather than licensed marketing entities, and referral bonuses dressed up as “consulting” or “administrative” fees. Even well-intentioned facilities can end up structuring a deal that looks fine on paper but functions as a kickback in practice.
If You Have Been Contacted, Do Not Wait
These cases rarely start with a knock at the front door. They usually begin with a subpoena, an investigator’s phone call, or a civil complaint that references transactions going back years. If your practice, treatment facility, or marketing arrangement has drawn attention from regulators or opposing counsel, the time to get ahead of it is now, not after charges are filed.
Our West Palm Beach civil RICO attorneys at Pike & Lustig, LLP regularly defend medical facilities, physicians, and marketing companies against patient brokering, anti-kickback, and civil RICO allegations across Palm Beach, Broward, and Dade counties. Call us before you respond to any investigator, subpoena, or demand letter.
Source:
flsenate.gov/Laws/Statutes/2018/817.505
