[refurb]

That’s not how kickbacks work.

A doctor could easily tell a patient “if you go to this hospital for surgery, I’ll give you $100”

That’s still a kickback.

[Dylan16807]

Is the doctor doing that for fun?

If the doctor is getting any of the money, then that part is the kickback.

If the doctor really gets nothing extra, and the hospital gets nothing extra, then that's not a kickback, it's just weird.

[refurb]

Huh? If a company gives you a $5 rebate for buying 5 bottles of shampoo, then it gets extra sales.

So if a $5 grocery rebate a kick-back?

[Dylan16807]

Increased sales, when paid by the same entity that gets the rebate, are not a kickback.

If a doctor took money to steer you to a specific hospital, that would be a kickback.

If a hospital gives you a rebate and you're paying, that's not a kickback. But if a hospital gives you a rebate and your insurance is paying based on the non-rebated price, that's probably a kickback.

[refurb]

Precisely. PBM rebates are based on sales as well. Drug company gets more sales by making their drug “preferred” and PBM gets a rebate. It’s not a kickback.

[Dylan16807]

Precisely what? If the PBM gets money then that's not the customer. Being paid for marking something as preferred is a kickback.

If the PBM buys something themselves and gets money back, that wouldn't be a kickback.

Just like a customer buying something and getting money back.

But when you have a buyer on one side, and a separate entity getting the money back, that's probably a kickback.