Medicaid Meals — a program and DBA of Vista Verde Homes 501(c)(3) nonprofit | EIN: 99-1152633 | Salt Lake County, Utah, United States Effective Date: January 2026 | Last Updated: June 2026

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1. Purpose

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This policy sets the standards that Vista Verde Homes and its Medicaid Meals program ("the Organization," "we") follow to comply with the federal Anti-Kickback Statute (AKS), the federal beneficiary-inducement prohibition, and applicable state anti-kickback and fee-splitting laws. Because the Organization operates as a nonprofit information and referral resource connecting individuals to nutrition-support programs that may be paid for by federal health care programs (Medicaid and Medicare), these laws are directly relevant to how we operate, fund our activities, and structure our relationships with payers and partners.

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2. Scope

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This policy applies to all directors, officers, employees, volunteers, contractors, and agents of the Organization, and to all outreach, screening, navigation, referral, partnership, funding, and vendor arrangements conducted in the name of Vista Verde Homes or the Medicaid Meals program.

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3. Policy Statement

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It is the Organization's policy to conduct all activities with strict financial integrity and without offering, paying, soliciting, or receiving any remuneration in exchange for referrals of, or to induce the use of, items or services reimbursable by a federal health care program. We do not steer individuals to particular providers, we do not accept or pay referral-based compensation, and we do not offer inducements to beneficiaries. We are compensated only for bona fide services we perform (marketing, outreach, education, and navigation), on a fixed-fee basis, paid by managed care plans or Social Care Networks — never by food vendors, and never tied to the volume or value of referrals. Nonprofit status does not exempt the Organization from these laws; compliance is mandatory regardless of tax status.

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4. Legal Framework

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Federal Anti-Kickback Statute (42 U.S.C. § 1320a-7b(b)). A criminal statute that prohibits knowingly and willfully offering, paying, soliciting, or receiving any remuneration — directly or indirectly, in cash or in kind — to induce or reward (a) referrals of items or services reimbursable by a federal health care program, or (b) the purchasing, leasing, ordering, or recommending of such items or services. An arrangement can violate the AKS if even one purpose of the remuneration is to induce referrals. Penalties include criminal fines, imprisonment, civil monetary penalties, and exclusion from federal health care programs.

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Beneficiary Inducement CMP (§ 1128A(a)(5)). Prohibits offering or transferring remuneration to a Medicare or Medicaid beneficiary that is likely to influence the beneficiary's selection of a particular provider, practitioner, or supplier.

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Safe Harbors (42 C.F.R. § 1001.952). Regulatory safe harbors describe arrangements that will not be treated as kickbacks if they meet all stated conditions. The personal-services/management-contracts safe harbor (§ 1001.952(d)) and the referral-services safe harbor (§ 1001.952(f)) are the most likely to be relevant. Safe-harbor protection is available only when every condition is precisely met; failing a safe harbor does not by itself make an arrangement illegal, but it removes the certainty the safe harbor provides.

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OIG Advisory Opinion 08-19. Guidance addressing a pay-per-lead/pay-per-call referral model and an advertising arrangement. OIG found minimal AKS risk based on a combination of factors that this policy adopts as operating principles (see Section 7).

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Seventh Circuit, United States v. Sorensen (2025). Narrowed what counts as a "referral" in a marketing context, emphasizing that arrangements are lower-risk where the ultimate decision-makers (consumers and/or physicians) retain independent control and the intermediary does not drive the healthcare decision.

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State laws. State anti-kickback and fee-splitting laws may be broader than federal law (applying to all payers), stricter, offer fewer safe harbors, and sometimes require a lower standard of intent. The Organization specifically observes: New York Education Law § 6530(19) (fee-splitting); California Business & Professions Code § 650 (compensation for referrals); Florida's Patient Brokering Act (Fla. Stat. § 817.505); the Texas Occupations Code (improper solicitation of patients); and Massachusetts General Laws Ch. 175H.

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5. Key Definitions

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• Remuneration — anything of value, directly or indirectly, overtly or covertly, in cash or in kind, including fees, commissions, discounts, gifts, rebates, free or below-cost services, and revenue-sharing.

• Referral — recommending, arranging for, or directing an individual to a provider, supplier, plan, or service.

• Federal health care program — any plan or program providing health benefits funded by the U.S. government, including Medicare and Medicaid.

• Fair market value (FMV) — the value of bona fide services in an arm's-length transaction, not adjusted to reflect the volume or value of referrals or business generated.

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6. Prohibited Conduct

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No person acting for the Organization may:

• Solicit, receive, offer, or pay any remuneration in exchange for referring, recommending, or arranging an individual's use of any item or service reimbursable by a federal health care program;

• Accept referral fees, "per-lead" or "per-call" fees, commissions, success fees, revenue-sharing, or any payment tied to the volume or value of referrals, enrollments, or services utilized;

• Accept any payment from a food vendor or other provider of federally reimbursable items or services in connection with referrals, navigation, or outreach;

• Pay or receive anything of value to feature, prefer, or recommend a particular provider;

• Offer money, gifts, discounts, fee waivers, or other items of value to a beneficiary to influence the selection of a provider or program;

• Tie any staff or contractor compensation, bonus, or incentive to the volume or value of referrals or to federally reimbursable business generated;

• Disguise prohibited remuneration as sponsorship, donation, grant, advertising, consulting, data, or administrative fees;

• Enter into any partner or vendor arrangement that has the purpose or effect of rewarding referrals.

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7. Operating Safeguards

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The Organization structures its activities to reflect the factors that minimize AKS risk:

• Funding and financial integrity. The Organization is funded through charitable sources and through a fixed fee paid by managed care plans, Social Care Networks, or other authorized entities for bona fide marketing, outreach, education, and navigation services. This fee is for services rendered, is set in advance, and is not based on the volume or value of referrals, leads, enrollments, meals, or any item or service reimbursable by a federal health care program. We receive no commissions, referral fees, per-lead/per-patient fees, revenue-sharing, or outcome-based payments, and we receive no payment from food vendors or other providers of reimbursable services. 

• Payment source and vendor neutrality. Our only compensation for these activities comes from the authorized payer (the managed care plan / Social Care Network), never from food vendors or downstream providers. We make no direct referrals to end vendors; interested individuals are directed to the authorized SCN/portal, where the individual chooses their own vendor.

• No steering; preserve choice. We present available options neutrally and, where multiple qualifying options exist, encourage individuals to compare and choose. We do not recommend or favor any provider. (See the Non-Solicitation & Non-Steering Policy.)

• Independent decision-making preserved. Eligibility, enrollment, vendor selection, and clinical/service decisions are made independently by individuals and by authorized providers, plans, and agencies — not by the Organization.

• No targeting of federal beneficiaries. Our public, educational outreach is directed to the general public, is not designed or priced to specifically generate federal health care program business, and does not depend on whether an individual is a federal program beneficiary.

• Fixed, FMV terms for services. Compensation the Organization receives for services, and any compensation it pays for bona fide services (e.g., technology, administration), is set in advance, consistent with FMV, structured where applicable under the personal-services and management-contracts safe harbor (42 C.F.R. § 1001.952(d)), and not determined in a manner that accounts for the volume or value of referrals.

• Transparency. We clearly disclose our nonprofit, non-governmental status and the nature of our role in all materials.

• No beneficiary inducements. We offer beneficiaries no remuneration to influence provider selection.

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8. Arrangements, Contracts, and Funding Review

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Before the Organization enters into any payer, partner, vendor, sponsorship, grant, data, or other financial arrangement that touches referral, navigation, or outreach activities, the arrangement must be reviewed and approved under this policy. Required elements include: a legitimate, documented business or charitable purpose; written terms; compensation (if any) fixed in advance and at FMV, not tied to referral volume/value; confirmation that no payment comes from, or is conditioned on referrals to, food vendors or other providers of reimbursable services; and, where applicable, fit within a recognized safe harbor or a documented risk assessment by counsel. All such arrangements are documented and retained.

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9. Staff and Contractor Compensation

 

Compensation for employees, volunteers, and contractors must not be based, in whole or in part, on the volume or value of referrals or on federally reimbursable business generated. Bonuses or incentives tied to referral counts, enrollments, or utilization are prohibited. Permissible compensation is based on fixed salary/wages or bona fide, FMV payment for actual services.

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10. Gifts, Inducements, and Beneficiary Interactions

 

The Organization does not provide cash, gift cards, or items of value to beneficiaries to influence provider selection, and does not condition assistance on choosing a particular provider. Nominal, non-targeted educational materials that carry no provider-selection influence are permitted.

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11. Training

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All personnel receive training on this policy at onboarding and at least annually thereafter, covering the AKS, beneficiary inducement, non-steering, financial integrity, and how to raise concerns. Training is documented.

 

12. Monitoring, Auditing, and Recordkeeping

 

The Organization maintains records of outreach materials and scripts, payer/partner/vendor agreements, funding sources, consents, referral interactions, and complaints, to demonstrate that referrals are neutral and free of prohibited remuneration. The Compliance Officer periodically reviews arrangements and a sample of referral activity for compliance and audit readiness. 

 

13. Reporting Concerns and Non-Retaliation

 

Anyone who suspects a violation of this policy or applicable law must report it promptly to the Compliance Officer at info@medicaidmeals.org [or a dedicated compliance address/hotline]. Reports may be made confidentially. The Organization prohibits retaliation against any person who reports a concern in good faith.

 

14. Investigation and Corrective Action

 

Reported concerns are documented, investigated, and addressed. Where a violation is found, the Organization will take corrective action, which may include modifying or terminating the arrangement, disciplinary action up to termination, repayment or disgorgement where appropriate, and, where required, disclosure to the relevant authority on advice of counsel.

 

15. Discipline

 

Violations of this policy may result in disciplinary action up to and including termination of employment or of the partner/vendor relationship.

 

16. Review

 

This policy is reviewed at least annually, and additionally when relevant federal or state laws, regulations, safe harbors, or OIG guidance change, or when the Organization expands into new states or arrangements.

 

17. Contact

 

Vista Verde Homes — Medicaid Meals Program Salt Lake County, Utah, United States Email: info@medicaidmeals.org