Which of the following activities may be considered a violation of the Anti-Kickback Provision?

Referral fees to patients represent a violation of the Anti-Kickback Provision because this provision is designed to prevent improper financial incentives that could influence medical decisions and lead to unnecessary or inappropriate services. When a medical service provider offers payment in exchange for referring patients, it creates a conflict of interest and undermines the impartiality of medical treatment. The purpose of the Anti-Kickback law is to ensure that decisions regarding patient care are based on the best interests of patients rather than financial gain.

In contrast, the other activities listed, such as offering free examinations, providing education to patients, and distributing promotional material, can often be legitimate practices aimed at helping patients access care and understand treatment options. These activities typically do not involve direct financial incentives to patients for referrals and are generally allowable under ethical medical practices, given that they comply with regulatory guidelines.