What is required regarding referral payments or fee sharing?

• A. Referral payments are prohibited entirely.
• B. Referral fees may be shared with staff without disclosure.
• C. There are no rules governing referrals.
• D. Any referral arrangements must comply with ethics and TBCE rules; avoid improper kickbacks or conflicts of interest.

Answer: (D)

Referral arrangements are not left to informal practice; they are governed by ethics rules and the TBCE standards. The best answer reflects that any referral arrangement must comply with ethics and TBCE rules and must avoid improper kickbacks or conflicts of interest. This framing protects patient care and professional integrity by ensuring compensation is not tied to steering referrals and that disclosures and fair considerations are in place. The other statements contradict the regulatory framework: outright prohibition ignores permissible, compliant arrangements; sharing with staff without disclosure breaches transparency and ethics; and saying there are no rules denies the governing standards you must follow.