>>>>As I read it, no MD's were penalized here. If so, that's insane.
>>There should at least have been a clawback of the kickbacks, although I'd have liked to see some jail time.
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>>Not only does it breach the AMA's ethical guidelines, my understanding is that paying these sorts of kickbacks is criminal under US law. The problem presumably is that physicians can argue that they were not influenced by the spending and it may be fearfully difficult to prove otherwise if a hospital needs the equipment and that supplier was a strong contender; whereas payers usually have whistleblowers who provide the required smoking gun.
>
>If the payor says it's a kickback, does what the payee says matter?

Statute [42 U.S.C. § 1320a-7b(b)] prohibits any party from making or accepting any form of payment—cash, or in kind—that is intended to encourage or reward a healthcare provider or purchaser to recommend, prescribe, or purchase any good or service that can be reimbursed or paid for by a federally-funded healthcare program, such as Medicare or Medicaid. In the case of the pharmaceutical industry, the law prohibits pharmaceutical companies from giving physicians undue incentives for prescribing their products if reimbursable under a government health program. All parties involved in pharmaceutical kickback schemes are liable for their actions.

However... identifying pharmaceutical kickbacks isn't always that easy because it's not always just a cash bribe, and there are certain exemptions, or “safe harbors, Essentially, illegal pharmaceutical kickbacks are those designed to increase the pharmaceutical company’s market share by influencing physicians’ choices about what to recommend or prescribe for their patients.