Which of the following actions is prohibited by the Anti-Kickback Statute (AKS)?

The Anti-Kickback Statute (AKS) is designed to prevent healthcare fraud and abuse by prohibiting any remuneration, including kickbacks, that may influence the referral of patients or the generation of business involving federal healthcare programs. The action of requesting more business and offering payment for it directly violates the essence of the AKS. Such conduct creates a conflict of interest, where financial incentives could improperly influence healthcare decisions, potentially leading healthcare providers to recommend unnecessary services or engage in excessive referrals solely for the benefit of financial gain.

In contrast, offering discounts for services is generally permissible within certain regulations, as it does not necessarily involve bribery or improper financial incentives. Providing free samples of medications can serve a legitimate purpose of allowing healthcare providers to assess whether a treatment is effective before making a full prescription. Referral incentives for insurance companies might be subject to regulatory scrutiny, but they do not inherently violate the AKS unless they are structured in a way that implicates illegal remuneration for patient referrals. Therefore, the action that unequivocally contravenes the AKS is the act of requesting more business and offering payment for it.