State Codes and Statutes

State Codes and Statutes

Statutes > North-carolina > Chapter_90 > GS_90-406

§ 90‑406.  Self‑referralsprohibited.

(a)        A health care provider shall not make any referral of anypatient to any entity in which the health care provider or group practice orany member of the group practice is an investor.

(b)        No invoice or claim for payment shall be presented by anyentity or health care provider to any individual, third‑party payer, orother entity for designated health care services furnished pursuant to areferral prohibited under this Article.

(c)        If any entity collects any amount pursuant to an invoice orclaim presented in violation of this section, the entity shall refund suchamount to the payor or individual, whichever is applicable, within 10 workingdays of receipt.

(d)        Any health care provider or other entity that enters into anarrangement or scheme, such as a cross‑referral arrangement that thehealth care provider or entity knows or should know is intended to inducereferrals of patients for designated health care services to a particularentity and that, if the health care provider directly made referrals to suchentity, would constitute a prohibited referral under this section, shall be inviolation of this section. (1993, c. 482, s. 1.)