Patient brokering
Patient brokering is paying or receiving anything of value in exchange for referring patients to a healthcare provider or facility — prohibited by state laws such as Florida’s Patient Brokering Act that, unlike the federal Anti-Kickback Statute, apply to cash-pay and privately insured patients as well as government programs.
- State-law prohibition on paying for referrals
- Applies to cash-pay patients
- Florida and Texas are the best-known examples
- Criminal penalties in several states
Why cash-pay programs cannot ignore it
The federal Anti-Kickback Statute reaches only items and services paid for by federal healthcare programs, so cash-pay telehealth largely sits outside it. State patient-brokering and all-payer anti-kickback laws close that gap: Florida, Texas, and a number of other states prohibit paying for patient referrals regardless of who pays for the care, and several carry criminal penalties.
What it looks like in telehealth marketing
Per-patient bounties to affiliates or partners, revenue shares paid to referrers out of clinical fees, and cash rewards to patients scaled to what they spend are the patterns that draw scrutiny. Flat fees for marketing services at fair market value, fixed per-lead affiliate payments from the brand’s marketing budget, and FTC-compliant creator sponsorships are the conventional alternatives.
- Payment for marketing services: generally defensible
- Payment per patient or per prescription: the pattern to avoid
- Payer source does not matter under state law
- Applies to the payer and the recipient
Compliance handled, so you can build
Lithos runs the clinicians, pharmacies, and 50-state rules behind your care program — one API.
Frequently asked questions
Does patient brokering law apply if we do not bill insurance?
In states with all-payer statutes, yes. The payer source is irrelevant; the question is whether something of value was exchanged for a referral.
Can we run an affiliate program for a telehealth brand?
Affiliate marketing is common; structure matters. Fixed payments for marketing services or qualified leads, paid by the brand, are the conventional approach. Payments measured by prescriptions or clinical revenue are what the statutes target. Review with counsel.
How does this relate to fee splitting?
Fee-splitting rules attach to licensed clinicians sharing professional fees; patient-brokering laws attach to anyone paying for referrals. The same arrangement can violate both.