Healthcare matters · National preparation support
Anti-Kickback Investigation: Preparing a Factual Record
Organize referral arrangements, compensation records and your individual responsibilities for counsel in an Anti-Kickback Statute investigation.
By Joseph De Gregorio · Federal Sentencing Strategist
Founder and President, Sentencing Advocacy Group · November 6, 2026
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Identify the arrangement under review
HHS OIG describes the Anti-Kickback Statute as addressing certain remuneration connected to federal healthcare program business. Counsel must evaluate the law and the specific arrangement. Begin with the contracts, parties, dates and services described in the records. Do not label an arrangement lawful or unlawful based solely on its title or the presence of a written agreement.
Build a contract-and-payment chronology
Keep signed agreements, amendments, invoices and payment records together by period. Record what services the documents describe and where evidence of performance is located. Distinguish fixed fees, variable payments and other benefits without assuming their legal significance. Preserve originals and mark missing versions.
Separate personal knowledge from organizational activity
Identify what you negotiated, approved, performed or learned about, and when. A company’s payments do not by themselves describe your individual knowledge or responsibilities. Conversely, a limited title should not be used to omit actions you actually took. Counsel needs a candid account supported by records.
Leave valuation and legal analysis to qualified reviewers
Fair-market-value, commercial-reasonableness and safe-harbor questions require appropriate expertise and legal review. A preparation timeline is not an opinion on any of those questions. Make the relevant source records easy to locate and keep questions separate from conclusions.
Document changes without rewriting the past
If arrangements changed, preserve the prior and revised versions and record who authorized the change. Training, oversight and revised approval practices should be described with dates and evidence of implementation. Counsel decides how any corrective work should be characterized or used.
Continue your preparation
- Civil and Criminal Healthcare Matters
- Healthcare Fraud: Individual Role Records
- Healthcare Fraud: Documenting Corrective Work
Does a written contract resolve the legal question?
No. Counsel must evaluate the arrangement and actual conduct under the applicable law. Preserve both the contract and records of what happened in practice.
Sources and professional scope
Official context: HHS OIG’s overview of healthcare fraud and abuse authorities. Its overview is educational and includes historical penalty figures; consult current authorities with counsel. U.S. Sentencing Commission guidelines resources support counsel’s sentencing review. Sources checked November 6, 2026.
SAG provides personal and professional chronology, source indexing, interview preparation and practical planning within a written scope. Retain qualified federal defense counsel for investigation-stage legal decisions. SAG is not a law firm and does not provide legal advice, clinical opinions or forensic accounting. An engagement does not automatically establish privilege.
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