Catch of the Week: Sanford Health to pay over $20M for kickback, unnecessary spinal surgery claims brought by two Sanford doctors
Posted 10/30/19
Anti-Kickback and Stark
This archive displays posts tagged as relevant to the Anti-Kickback Statute and Stark Law.
You may also be interested in the following pages:
October 28, 2019
Atheir Amarrah, the owner of Michigan-based Prompt Care Home Health Services Inc, has been sentenced to 5 years in prison and ordered to pay $1 million in restitution after pleading guilty to paying recruiters for referrals to Medicare beneficiaries. In his guilty plea, Amarrah also admitted to billing Medicare for claims tainted by illegal kickbacks. DOJOctober 28, 2019
Sanford Health, Sanford Medical Center, and Sanford Clinic have agreed to pay $20.25 million and enter into a Corporate Integrity Agreement in order to resolve alleged violations of the Anti-Kickback Statute and False Claims Act. Despite warnings by several physicians that a top neurosurgeon was illegally profiting off his use of implantable medical devices as well as performing medically unnecessary surgeries involving the devices, Sanford did nothing to stop the offender, allowing Medicare and Medicaid to continue being defrauded. The allegations were raised by Sanford surgeons Drs. Carl Dustin Bechtold and Bryan Wellman, who will share in a $3.4 million cut of the settlement proceeds. DOJ; USAO SDOctober 25, 2019
Two foundations that provide pharmaceutical co-payment assistance to patients have reached agreements to resolve claims that they failed to operate independently of their pharmaceutical company donors and violated or caused the violation of the False Claims Act and Anti-Kickback Statute by working with those companies to ensure that donations received from them would be used to cover co-payments for the donor's drugs, inducing patients to purchase the drugs. The Chronic Disease Fund, Inc. will pay $2 million, and the Patient Access Network Foundation will pay $4 million, amounts that were arrived at based on the entities' abilities to pay. CDF was alleged to have conspired with Novartis, Dendreon, Astellas, Onyx, and Questcor. PANF was alleged to have conspired with Bayer, Astellas, Dendreon, and Amgen. The foundations also entered into 3-year corporate integrity agreements. USAO MAOctober 9, 2019
Genetic testing company UTC Laboratories, Inc. (RenRX), along with three principals, have agreed to pay a combined $42.6 million to settle six suits alleging violations of the Anti-Kickback Statue and False Claims Act. Between 2013 and 2017, RenRX and principals Tarun Jolly, M.D., Patrick Ridgeway, and Barry Griffith allegedly paid cash bribes to physician entities and individuals to induce orders of medically unnecessary pharmacogenetic tests that were subsequently billed to Medicare. As part of the settlement, RenRX also agreed to a twenty-five year period of exclusion from participating in any federal healthcare program. USAO EDLAOctober 4, 2019
Florida man Brock Lovelace has been sentenced to nearly six years in federal prison following his conviction at trial on charges related to his payment of kickbacks to medical clinics in the Miami area in exchange for the clinics providing him with DNA samples for submission to a DNA testing laboratory between 2013 and 2014. Lovelace requested that the medical clinics collect the DNA of all the patients who visited the clinics; in turn, the clinics provided food and other inducements to beneficiaries to get them to visit. Lovelace then submitted the DNA swabs to a testing lab, which billed Medicare. The patients were not provided with the results of the DNA testing, and typically did not have any medical need for the DNA testing. Lovelace was previously sentenced to 14 years in prison on other healthcare fraud charges; he will serve the present sentence consecutively. DOJOctober 3, 2019
Glenn A. Kline and Community Surgical Associates of Lancaster, Pennsylvania, will pay $4.25 million to resolve claims that Dr. Kline entered into an unlawful kickback arrangement with two hospitals owned by Health Management Associates in exchange for his referral of patients to the hospitals. The hospitals paid Dr. Kline far above fair market value for his services, and made additional payments to Community Surgical Associates, structuring those payments to conceal their purpose. HMA previously paid $260 million to resolve related claims; physician groups, EmCare Inc. and Physician’s Alliance Ltd, agreed to pay more than $33 million; and, former HMA CEO Gary Newsome agreed to pay $3.5 million. The claims against Kline and Community Surgical were original made in a qui tam complaint filed by former HMA executives George Miller and Michael Metts; they will receive $1.05 million of the settlement. USAO ED PASeptember 27, 2019
In an investigation dubbed Operation Double Helix, charges have been brought against 35 defendants associated with a number of telemedicine and cancer genetic testing laboratories involved in a scheme that resulted in the submission of more than $2.1 billion in fraudulent Medicare claims. Cancer genetic testing laboratories involved in the scheme are alleged to have paid illegal kickbacks to providers and others working with fraudulent telemedicine companies in exchange for the referral of Medicare beneficiaries for expensive and medically unnecessary cancer genetic tests, which Medicare was then billed for. Some of the defendants allegedly controlled a telemarketing network that lured hundreds of thousands of elderly and/or disabled patients into signing up for unnecessary genetic tests, often without any interaction with the provider who would prescribe the testing. DOJ; USAO ED LACatch of the Week: Avanir Pharmaceuticals
Posted 09/27/19
