In a recent a case, a home health owner pleaded guilty to paying kickbacks and billing for services that were never provided or were not medically necessary (of course).  The kickbacks were paid through sham employment agreements/relationships.  I believe a more scrutinous look at the necessity of those employment arrangements would have revealed something inappropriate and commercially unreasonable.  But, healthcare providers and owners need to consult their attorneys in order for these problematic arrangements to be identified.