CLE Approved – S1E6: EKRA – The Law That Changed How Behavioral Health Does Business

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In the latest episode of Almost Clinical, hosts and healthcare attorneys Vincent Buttaci, John Leardi, and Paul Werner dissect the Eliminating Kickbacks in Recovery Act (EKRA) and what the recent Ninth Circuit decision means for behavioral health providers, labs, and investors.

EKRA isn’t just another compliance acronym – it’s the law that upended how behavioral health operators, treatment facilities, and clinical labs market and grow their businesses. What began as Congress’s response to rampant patient-brokering and kickback schemes has evolved into one of the broadest and most unforgiving enforcement tools in healthcare.

Vincent, John, and Paul explain how EKRA expanded beyond the Anti-Kickback Statute, why “creative” inducements can now carry criminal risk, and how the Ninth Circuit’s decision made it clear that third-party marketers and investors are not immune. They also dig into real-world scenarios – from “free” flights and charitable donations to commission-based pay – that illustrate just how easy it is to step over the line.

Listeners will learn:

• How EKRA closed the loopholes left by the Anti-Kickback Statute
• Why behavioral health became ground zero for kickback enforcement
• What the Ninth Circuit’s ruling changes for marketers and investors
• Why “intent” won’t protect you when enforcement comes calling
• How free housing, charitable donations, and profit sharing can cross the line
• What whistleblowers and DOJ pilot programs mean for operators
• Practical strategies for staying compliant without killing your business

Produced by Buttaci, Leardi & Werner, the healthcare law boutique helping providers and investors navigate what’s legal, what’s risky, and what’s next.

Join Almost Clinical hosts Vincent Buttaci, John Leardi, and Paul Werner as they challenge each other’s views on how to operate, invest, and succeed in healthcare’s rapidly shifting landscape, translate legalese into business sense for healthcare providers, executives, private equity professionals, and strategic stakeholders, and explore the issues shaping the business of medicine today and tomorrow.

• Posted on: Dec 13 2025