Referral outreach rules for specialists

Don't pay for referrals

The federal Anti-Kickback Statute (42 U.S.C. § 1320a-7b(b)) is a criminal law. It prohibits knowingly and willfully paying anything of value to induce or reward referrals of items or services payable by federal health care programs such as Medicare and Medicaid. It covers both sides: whoever offers or pays, and whoever solicits or receives. Penalties include fines, prison and exclusion from federal health care programs (HHS Office of Inspector General).

Even where no federal program pays, the ADA Code of Ethics is direct. Section 4.E reads: "Dentists shall not accept or tender 'rebates' or 'split fees.'" The ADA's advisory opinion adds that this applies to any third party, and that paying a marketing vendor a set amount or a percentage of fees collected from patients is fee splitting (ADA Principles of Ethics and Code of Professional Conduct).

Physicians and the Stark Law

The federal physician self-referral law, known as the Stark Law, prohibits a physician from making referrals for certain designated health services payable by Medicare to an entity with which the physician, or an immediate family member, has a financial relationship, unless an exception applies (CMS). OIG describes the Stark Law as a strict liability statute, so intent is not required (HHS OIG). If your practice has a financial relationship with a referring physician or practice, get advice before you reach out.

Gifts, lunches and events

Lunch-and-learns, continuing-education events and referral pads are everyday parts of referral relationships. The line the law draws is intent: anything of value offered to induce or reward referrals can fall under the Anti-Kickback Statute when federal programs pay for the care. Keep events educational, don't tie anything to referral volume, and ask a health-care attorney before you plan anything larger than a modest team lunch.

Send patients back

Under Section 2.B of the ADA Code, a specialist returns a referred patient to the referring dentist for future care when treatment is complete, unless the patient expressly prefers otherwise (ADA Code). Referring dentists notice when you do this, and it is the best argument for the next referral.

Emailing referring offices

The FTC says CAN-SPAM covers all commercial email and "makes no exception for business-to-business email" (FTC compliance guide). A marketing email to a dental office needs:

• Accurate sender and header information
• A subject line that isn't misleading
• A clear disclosure that the message is an ad
• Your practice's valid physical postal address
• A clear way to opt out, honored within 10 business days

The same guide says transactional or relationship messages are exempt from most provisions, so a note about a shared patient is different from a marketing email. Leadaura only gives you business contact details for offices, never patient data.

A short checklist

1. No payments tied to referrals

   No fees, rebates or percentages to dentists or to marketing vendors based on patients referred or fees collected.

2. Keep events educational

   CE, case reviews and modest team lunches, not rewards for volume.

3. Return every patient

   Send the patient and a report back to the referring dentist when treatment is done.

4. Email honestly

   Your name and practice, a real subject, your postal address and an opt-out you honor.

5. Ask when unsure

   Your state dental board and a health-care attorney have the final word for your state.

This page summarizes public sources and isn't legal advice.

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