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Page 26 of 45

August 2, 2018

William Beaumont Hospital will pay $82.74 million to the federal government and $1.76 million to the state of Michigan to settle allegations made by four separate whistleblowers that between 2004 and 2012 it paid doctors above fair market value and provided them with perks such as free or discounted office space in return for patient referrals. Beaumont also allegedly falsely claimed that a CT radiology center qualified as an outpatient department. Beaumont has now entered into a five-year Corporate Integrity Agreement with the Department of Health and Human Services Office of Inspector General. It is not yet determined how much money the four whistleblowers will receive. DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, FCA State, Healthcare Fraud, Hospital Fraud, Whistleblower Case, Whistleblower Rewards,

July 16, 2018

Two additional Southern California surgeons have been indicted in a kickback scheme that is alleged to have generated over a billion dollars in fraudulent claims to federal and California healthcare programs. The two physicians were charged for their roles in receiving kickbacks to refer patients to Pacific Hospital. USAO Central District of California

Tagged in: Anti-Kickback and Stark, Provider Fraud,

July 16, 2018

Healthquest, Inc. and its owners have settled FCA allegations for $1.5M. According to the government, the home health care company, paid kickbacks to marketers to induce patient referrals. The company has also entered into a 5 year corporate integrity arrangement. The allegations were first brought by a whistleblower, a former marketer, who will receive $300K. USAO Southern District of Florida

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Home Health and Hospice, Whistleblower Case, Whistleblower Rewards,

July 9, 2018

NY-based Health Quest Systems, Inc. (Health Quest), and its subsidiary hospital Putnam Health Center (Putnam) entered a $14.7 million settlement with DOJ and a $895,427 settlement with New York based on their submission of inflated and otherwise impermissible claims for payment to Medicare and Medicaid.  Specifically, the defendants billed Medicare for undocumented E&M services, billed for home-health services without supporting medical records, and billed for orthopedic surgeons who referred patients in violation of the Physician Self-Referral Law, also known as the Stark Law.  Three former Health Quest employees, who filed suit under the qui tam provisions of the False Claims Act, will receive a share of the recovery, including a reward of nearly $2 million to one of the relators.  DOJ; USAO NDNY

Tagged in: Anti-Kickback and Stark, FCA Federal, FCA State, Healthcare Fraud, Hospital Fraud, Medical Billing Fraud, Whistleblower Case, Whistleblower Rewards,

June 29, 2018

Nermin Awad El-Hadik was sentenced to five years in prison for his role in paying kickbacks to a medical provider. El-Hadik paid more than $5.3 million in a kickback scheme in exchange for referrals of injured employees covered by the Department of Labor Federal Employees’ Compensation Act. El-Hadik was also ordered to pay over $5.3 million in restitution. USAO WDTX

Tagged in: Anti-Kickback and Stark, Healthcare Fraud,

June 13, 2018

Brothers David Nicoll and Scott Nicoll, who held senior positions at New Jersey-based Biodiagnostic Laboratory Services LLC, were sentenced to prison terms for their respective roles in a physician kickback scheme that resulted in over $100 million in blood sample referrals to the diagnostic lab company. To date, 53 defendants have been convicted as a result of the investigation. The now defunct lab company pleaded guilty and was ordered to forfeit all of its assets in June 2016. USAO NJ

Tagged in: Anti-Kickback and Stark, Healthcare Fraud,

May 31, 2018

New York doctor Thomas Savino was sentenced to four years in prison, fined $100,000, and ordered to forfeit $27,500 for violating the AKS and other laws by accepting at least $25,000 in cash brides from Biodiagnostic Laboratory Services LLC in exchange for referring patient blood samples to the lab. USAO DNJ

Tagged in: Anti-Kickback and Stark, Healthcare Fraud, Provider Fraud,

May 29, 2018

Following a two-week jury trial, LaTonya Mallory, Floyd Calhoun Dent III, and Robert Bradford Johnson were collectively found liable for $114 million for violating the False Claims Act and Anti-Kickback Statute by paying physicians for patient referrals to two blood-testing laboratories, and for causing those laboratories to bill federal health care programs for medically unnecessary testing. The verdict resolves three separate whistleblower suits filed by Dr. Michael Mayes, Scarlett Lutz, Kayla Webster, and Chris Reidel, who will receive a yet-to-be-determined share of any recoveries. USAO DDC

Tagged in: Anti-Kickback and Stark, FCA Federal, Lack of Medical Necessity, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

May 24, 2018

Pharmaceutical giant Pfizer agreed to pay $23.85 million and enter in to a corporate integrity agreement to resolve claims under the False Claims Act that it induced Medicare patients to use three Pfizer drugs, Sutent, Ilyta, and Tikosyn, by unlawfully covering patients copays in violation of the AKS; in doing so, Pfizer increased its profits and masked the effect of drug price increases. DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Pharma Fraud,

May 17, 2018

Five New Jersey salesmen were sentenced to prison terms ranging from 21 to 41 months for their role in violating the AKS and other laws by bribing doctors-with cash, sham consulting fees, and other means of payment-for patient blood specimen referrals. USAO DNJ

Tagged in: Anti-Kickback and Stark, Healthcare Fraud,

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