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May 17, 2018

New Orleans physician Jobie Crear was sentenced to 8 months in prison and ordered to pay more than $810,000 to Medicare for his role in an illegal kickback conspiracy in which he paid recruiters to bring Medicare patients to a nursing and home health services company he operated. USAO EDLA

Tagged in: Anti-Kickback and Stark, Healthcare Fraud, Home Health and Hospice,

May 10, 2018

Cincinnati-based non-profit Mercy Health, which operates healthcare facilities in Ohio and Kentucky, agreed to pay $14,250,000 to settle allegations that it violated the False Claims Act and Stark Law by engaging in improper financial relationships with referring physicians. Specifically, the government alleged that Mercy Health provided compensation to six employed physicians that exceeded the fair market value of their services. DOJ

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

May 7, 2018

Dr. Robert Fetchero, Dr. Sridhar Pinnamaneni, and Dr. Thelma Green-Mack agreed respectively to pay $200,000, $370,000 and $130,000 to settle allegations that they violated the False Claims Act, Anti-Kickback Statute, and the Stark Law by receiving improper payments for referrals from Pennsylvania-based drug testing lab Universal Oral Fluid Laboratories. According to the government, these physicians referred Medicare patients to Universal for drug testing services while engaged in a financial relationship with the lab. (DOJ (WDPA)

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

April 26, 2018

Tennessee physician Brenna Green paid roughly $200,000 to settle claims she violated the False Claims Act, the Stark Law and the Anti-Kickback Statute for her role in a kickback scheme with Southwest Laboratories, Medscan Laboratory, and sales representatives affiliated with Southwest and Medscan. According to the government, Green acquired shares in Southwest for a nominal sum in exchange for a guaranteed “dividend” of approximately $5,000 per month as long as she met or exceeded the number of urine drug screen referrals required by Southwest. DOJ (NDVA)

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

March 30, 2018

Larry B. Howard, the owner of an Orlando-based Fertility Pharmacy, was sentenced to serve 160 months in prison and forfeit over $4.3 million for his role in a kickback scheme involving pain and scar creams that resulted in the payment of approximately $4.3 million in false and fraudulent claims to TRICARE. DOJ

Tagged in: Anti-Kickback and Stark, Compounding Pharmacy Fraud, Other Government Health Programs,

March 29, 2018

Juan Yrorita, the assistant director of nursing at Detroit area home health agency Annointed Care Services, was sentenced to 36 months in prison and pay and forfeit roughly $50 million for his role in a scheme involving approximately $1.6 million in fraudulent Medicare claims for home health services that were procured through the payment of kickbacks, and that were medically unnecessary and not provided. DOJ

Tagged in: Anti-Kickback and Stark, Home Health and Hospice, Lack of Medical Necessity,

March 29, 2018

Georgia Bone & Joint, Southern Bone & Joint (a/k/a Summit Orthopaedic Surgery Center), Southern Crescent Anesthesiology, PC, Sentry Anesthesia Management, LLC, and David LaGuardia agreed to pay $3.2 million to settle claims they violated the False Claims Act and Anti-Kickback Statute. Specifically, the government alleged that LaGuardia, Sentry, and Southern Crescent provided a free medical director to Summit Surgery Center to induce it to choose to perform more procedures at the surgery center rather than in the Georgia Bone office. The government further alleged that Georgia Bone and LaGuardia caused the submission of false claims to Medicare for prescription drugs purchased outside the United States and not approved by the FDA. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Sharon Kopko, former Practice Administrator for Southern Bone. She will receive a yet-to-be determined award from the proceeds of the government’s recovery. DOJ (NDGA)

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

March 29, 2018

Texas-based SightLine Health LLC, which operates radiation therapy centers throughout the United States, agreed (together with its parent Oncology Network Holdings) to pay up to $11.5 million settle claims  it violated the False Claims Act and Anti‑Kickback Statute. According to the government, SightLine targeted physicians that were able to refer patients to its cancer treatment centers, and paid those physicians a share of its profits. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act. The whistleblower will receive an award of up to $1.725 million from the proceeds of the government’s recovery. DOJ

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

March 8, 2018

Massachusett’s-based Abiomed, Inc. agreed to pay $3.1 million to settle claims of violating the False Claims Act and Anti-Kickback Statute by purchasing lavish meals for physicians in order to induce them to use Abiomed’s Impella line of heart pumps. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by a former Abiomed employee. The whistleblower will receive an award of $542,500 from the proceeds of the government’s recovery. DOJ (MA)

Tagged in: Anti-Kickback and Stark, FCA Federal, Medical Devices and DME, Whistleblower Case, Whistleblower Rewards,

March 7, 2018

UPMC Hamot, affiliated with the University of Pittsburgh Medical Center, and Medicor Associates Inc., a regional physician cardiology practice, agreed to pay $20.7 million to settle charges of violating the False Claims Act, Anti‑Kickback Statute and Stark Law through Hamot's payment under twelve physician and administrative services arrangements to secure Medicor patient referrals. Hamot allegedly had no legitimate need for the services contracted for, and in some instances the services either were duplicative or were not performed. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Medicor employee Dr. Tullio Emanuele. He will receive a whistleblower award of roughly $6 million from the proceeds of the government's recovery. DOJ

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

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