Constantine Cannon Settles Case Alleging Kickbacks to Multi-Practice Physicians’ Group for Referrals to Wholly Owned Ambulatory Surgery Center – Whistleblower Was Former CEO
Posted 10/9/20
Anti-Kickback and Stark
This archive displays posts tagged as relevant to the Anti-Kickback Statute and Stark Law.
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October 2, 2020
Pharmatech, Inc. and its CEO and founder Tuan Pham will pay over $3 million to settle allegations in a case initiated as a qui tam action under the False Claims Act. The government alleged that defendants violated the Anti-Kickback Statute by paying a medical clinic, Imperial Valley Wellness, a per-specimen fee to induce it to refer orders for laboratory drug-testing to Phamatech which were subsequently billed to Medicare. Many of the tests were also alleged to be not medically necessary. The whistleblower, former Pharmatech employee John Polanco, will receive over $500,000 from the settlement. USAO SD Cal.October 2, 2020
Advanced Pain Management Holdings, Inc. and its subsidiaries will pay $1 million to resolve claims brought by a whistleblower under the False Claims Act. Defendants, which run ambulatory surgical centers, were alleged to have violated the Anti-Kickback Statute by improperly gifting incentive stock shares to non-employee physicians allegedly as a reward for past and anticipated referrals to APMH facilities, and by paying those physicians “medical director” fees tied to the volume of procedures at APMH facilities, without proper documentation of the agreement. In addition, defendants were alleged to have performed unnecessary confirmatory urine drug testing on patients. USAO ED WICatch of the Week: 345 Charged in $6 Billion National Health Care Fraud and Opioid Takedown
Posted 10/2/20
September 28, 2020
Lakeway Regional Medical Center, LLC will pay $1,119,177 to resolve allegations that the hospital submitted false claims to the Medicare and Medicaid programs in the form of claims for payment for services that were based on referrals from doctors offered investment in a joint venture to purchase and then lease the hospital back to LRMC. The government alleged that such an arrangement was unlawful under the Anti-Kickback Statute. The case was initiated by a qui tam complaint filed by Dr. Robert Van Boven and Sharon Van Boven. USAO WD TXSeptember 23, 2020
Gilead Sciences, Inc. has agreed to pay $97 million to resolve claims of paying kickbacks to Medicare beneficiaries in connection with its pulmonary arterial hypertension drug, Letairis. From 2007 to 2010, Gilead enticed beneficiaries to purchase Letairis by allegedly referring the beneficiaries to a foundation, Caring Voice Coalition (CVC), and then making payments to CVC to cover patient copays of Letairis specifically, in violation of the Anti-Kickback Statute and Medicare rules. Additionally, Gilead routinely obtained data from CVC that it used to inform future payments, including how many CVC clients were on Letairis, how much CVC spent on those clients, and how much CVC expected to spend on them in the future. DOJ; USAO MASeptember 22, 2020
New Jersey biotechnology company Bio-Reference Laboratories, Inc., will pay $11.5 million to resolve two actions brought by whistleblowers alleging that defendant violated the Anti-Kickback statute by paying unlawful remuneration to physicians based on the volume of those doctors’ referrals to defendant. The remuneration took the form of payments for a percentage of the cost of electronic medical records software used by the doctors. In addition, defendant was alleged to have unlawfully billed Medicare and Tricare for testing performed on hospital inpatients, instead of billing the hospitals themselves. USAO SDNYSeptember 9, 2020
West Virginia-based acute care hospital, Wheeling Hospital, Inc., has agreed to pay $50 million to resolve claims of violating the Anti-Kickback Statute, Physician Self-Referral (Stark) Law, and False Claims Act. According to a former executive turned whistleblower, Louis Longo, Wheeling knowingly provided referring physicians with compensation above fair market value, based on the volume or value of their referrals, then submitted claims resulting from those improper referrals to Medicare. As part of the settlement, Longo will receive a $10 million relator’s share. DOJ; USAO WDPA; USAO NDWVAugust 31, 2020
Brooklyn, New York resident Aleksander Pikus was sentenced to 13 years in prison and ordered to pay $39.4 million in restitution and forfeit $2.6 million following his conviction at trial for charges related to a kickback and tax avoidance scheme involving a number of medical clinics in Brooklyn and Queens. Pikus referred patients to the clinics, receiving kickbacks in exchange, which he used to pay patient recruiters and patients themselves. Pikus used shell companies and fake invoices to conceal his scheme and failed to report cash income to the IRS. DOJ; USAO ED NYTop Takeaways from Former DOJ Civil Chief Jody Hunt on the Current State of False Claims Act Enforcement
Posted 08/28/20
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- COVID-relief fraud will be a DOJ priority. No surprise there given the billions of dollars the federal government is pouring into the economy to alleviate some of the financial strain the pandemic is wreaking on healthcare providers...