EKRA compliance for treatment center marketing

What EKRA is

The Eliminating Kickbacks in Recovery Act (EKRA) is a federal law enacted in 2018 that prohibits paying or receiving kickbacks in exchange for referrals to recovery homes, clinical treatment facilities, and laboratories. Violations carry penalties up to $200,000 per violation and up to 10 years imprisonment.

What EKRA prohibits

Paying for patient referrals. Receiving payment for referring patients. Per-lead, per-call, or per-admission marketing fees (these may constitute kickbacks). Patient brokering. Revenue-sharing arrangements tied to patient volume. Commission-based referral relationships.

What EKRA allows

Flat-rate marketing and advertising fees not tied to patient volume. Bona fide employee compensation. Legitimate contracted services at fair market value. Directory listings with flat-rate fees (like Treatment Association's model). SEO services, website development, and content creation at flat rates.

Practical compliance

Structure all marketing relationships as flat-rate arrangements. Document the fair market value basis. Ensure no fee varies based on patient volume. Keep marketing and clinical operations separate. Train staff on EKRA requirements. Consult a healthcare attorney for complex arrangements.

Red flags

Any marketing company that charges per call, per lead, or per admission. Referral fees to interventionists, sober home operators, or other referral sources. Revenue-sharing arrangements. Incentive programs tied to patient referrals.

Ready to grow your census ethically?

Flat-rate marketing. No per-lead fees. EKRA compliant.

Sources

SAMHSA · ASAM · CARF

Frequently asked questions