Free Gifts, Referral Fees, and Lunches: What’s Actually Allowed Under AKS?

If you work in senior care and rely on Medicare or Medicaid reimbursement, the Anti-Kickback Statute (AKS) isn’t just legal fine print. It’s federal law with real consequences.

Yet in many agencies, there’s still confusion about what’s actually allowed. Can you give gift cards to referral partners? Host a lunch-and-learn with a local discharge planner? Offer a ride to a prospective client?

Let’s break down what the AKS covers — and how to market responsibly without putting your license (or reputation) at risk.

What Is the Anti-Kickback Statute?

The AKS is a federal law that prohibits offering, paying, soliciting, or receiving anything of value to induce or reward referrals for services reimbursable by federal healthcare programs like Medicare and Medicaid.

Violating the AKS can lead to:

• Civil monetary penalties
• Criminal charges
• Exclusion from federal healthcare programs

And it doesn’t matter if the intent was innocent or the dollar amount small. If it appears to influence referrals, it may be considered illegal.

"The statute is intent-based, meaning even perceived intent to induce a referral can trigger enforcement." — Office of Inspector General (OIG)

So What’s Actually Allowed? (And What’s Not?)

1. Referral Fees to Healthcare Professionals

Not allowed. You cannot pay a physician, social worker, or discharge planner for referring patients to your agency.

Safe alternative: Build genuine, educational relationships. Provide value through data, outcome reporting, or in-services.

2. Free Services or Gifts to Referral Sources

Usually not allowed. Even small gifts (coffee, lunch, gift cards) can be problematic if given routinely or with an expectation of referrals.

Safe alternative: If you host educational events, ensure they’re open to all and not linked to referral volume. Avoid personal gifts.

3. Free Items or Discounts to Patients

Heavily restricted. Giving potential patients free transportation, meals, or discounts can be interpreted as inducement.

Safe alternative: If offering non-monetary support (like a welcome folder or caregiver guide), keep value under $15 per item and $75 annually per patient, per OIG guidelines.

4. Educational Marketing Materials

Allowed. You can provide brochures, guides, handouts, and website content that educate patients and partners about your services — as long as they're factual, not promotional in tone, and not tied to any reward.

HIPAA Considerations

Remember: even if your marketing is AKS-compliant, it also needs to respect patient privacy. Don’t share testimonials, photos, or case stories without written authorization.

For dual compliance: build marketing that is both AKS-safe and HIPAA-secure.

What About Lunches and Swag?

A one-time catered lunch for a case management team may fall into a gray area if it’s educational and not tied to referrals. But repeated meals, logo pens, or gift bags? Those can get flagged quickly.

Rule of thumb: If it feels like a reward, it’s probably not compliant.

RaisedCare’s Take

We believe you can grow and stay compliant. At RaisedCare, we help senior care providers create ethical marketing strategies that build trust, not risk. You don’t need giveaways or bonuses to grow. You need clarity, storytelling, and systems that respect both the law and the people you serve.

Because the right kind of marketing never has to feel like a bribe.

Sources

• U.S. Department of Health & Human Services: Anti-Kickback Statute Overview
• OIG Compliance Guidance, Updated 2021
• CMS Marketing Guidelines for Providers