In the big focus on the opioid crisis, kickbacks that occur in the drug treatment arena have become the target of a little discussed Federal law enacted in February of 2018. The Eliminating Kickbacks in Recovery Act (EKRA) has provided stiff penalties (up to $200,000 and up to 10 years in jail or both) for paying or soliciting kickbacks in the recovery area to provide or refer for provision of care by a recovery home, clinical treatment facility or laboratory. There are a few exceptions for properly disclosed discounts, employment relationships, management contracts and other safe harbors similar to those under the Anti-kickback statute; and, this new law also applies to any federal health care benefit program. Although the targeted facilities are a narrow range of entities providing care in the drug treatment space, the definition of “laboratory” is as broad as that under the Public Health Service Act, which reaches most clinical laboratories in America. While treatment facilities and recovery centers have reason to pay attention, the implications for all laboratories are broader and the penalties twice as harsh as those under AKS.