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Anti-Kickback and Stark

This archive displays posts tagged as relevant to the Anti-Kickback Statute and Stark Law.

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November 9, 2021

Numerous anesthesia providers and outpatient surgery centers in Georgia, including Ambulatory Anesthesia of Atlanta, LLC and Northside Anesthesiology Consultants, LLC, have agreed to pay over $28 million to resolve kickback allegations by whistleblowers Kathleen Hartney-Velazco, M.D., Jan Kersey, and Capitol Anesthesiology, P.C., who will receive a $4.7 million cut of the settlement.  According to the whistleblowers, the anesthesia providers made payments and provided free staffing to the outpatient surgery centers in order to obtain exclusivity contracts over a ten-year period.  USAO NDGA

November 9, 2021

Kaléo, Inc., a pharmaceutical manufacturer in Virginia, has agreed to pay $12.7 million to resolve a whistleblower’s allegations that it violated the Anti-Kickback Statute and False Claims Act in claims submitted to Medicare, TRICARE, and the Federal Employees Health Benefits Program.  Between 2017 and 2020, kaléo allegedly provided kickbacks to physicians and their staff to induce and reward them for prescribing Evzio, a higher-priced version of a drug used to reverse opioid overdoses and which often requires prior authorization.  Kaléo also allegedly directed pharmacies to submit false prior authorizations and dispense Evzio without collecting required co-pays.  USAO MA

November 8, 2021

Florida-based medical device company Arthrex Inc. has agreed to pay $16 million and enter into a five-year corporate integrity agreement to resolve allegations of paying kickbacks to a Colorado-based orthopedic surgeon in exchange for the surgeon’s use and recommendation of its products.  According to a qui tam suit by whistleblower Joseph Shea, the kickbacks were disguised as royalty payments for the surgeon’s contributions to Arthrex’s SutureBridge and SpeedBridge products.  For his role in the case, Shea will receive a relator’s share of $2.5 million.  USAO MA

November 5, 2021

Two men who pleaded guilty to causing $134 million in false claims to be submitted to Medicare and CHAMPVA have been sentenced to federal prison and ordered to pay restitution of over $29 millionMichael Nolan of Florida was sentenced to 6.5 years, while Richard Epstein of Colorado was sentenced to about 5 years.  Using a telemarketing company called REMN Management LLC, as well as a telemedicine company called Comprehensive Telcare LLC, Nolan and Epstein had bribed physicians to sign medically unnecessary orders for durable medical equipment, which they then sold to co-conspirators as support for the false claims.  USAO MDFL

October 25, 2021

Curant, Inc., which owns pharmacies in Florida and Georgia, has agreed to pay $4.6 million to resolve allegations of paying kickbacks to a third-party marketer, waiving mandatory copays from patients, and overbilling TRICARE for compound pain and scar creams.  The alleged misconduct occurred between 2013 and 2015.  USAO NDGA

September 23, 2021

Index Systems, Inc. and Capital Consulting Group, Inc. (CCG), two government contractors in Virginia, have agreed to pay nearly $1.2 million to settle allegations of violating the False Claims Act and Anti-Kickback Act.  In order to fraudulently obtain Small Business Administration contracts reserved for businesses owned by socially or economically disadvantaged citizens, CCG—which was not eligible—allegedly conspired with Index to use Index’s certification to bid on the contracts, in exchange for kickbacks.  USAO EDVA

Catch of the Week: Bayada Home Health Care Settles Kickback Allegations for $17 Million in Case Demonstrating that Kickbacks Come in Many Forms

Posted  09/17/21
business person stamping a paper
Last week, Bayada Home Health Care, Inc., a national home health company with more than $1.5 billion in reported revenues and offices in twenty-two states, agreed to pay the United States $17 million to settle allegations that it violated the federal Anti-Kickback Statute (AKS).  The AKS prohibits paying illegal remuneration in any form to induce business or referrals paid for with federal health care dollars, and...

September 8, 2021

Bayada Home Health Care, Inc. and related entities agreed to pay $17 million to resolve allegations of paying unlawful kickbacks that were initiated by a whistleblower action under the False Claims Act.  The government alleged that Bayada purchased two home health care agencies from a company that owned retirement communities in order to induce referrals from the seller to Bayada.  The whistleblower, David Freedman, was the director of strategic growth for Bayada; he will receive more than $3 million as a whistleblower reward.  DOJ; USAO NJ

September 3, 2021

A number of South Carolina pain management clinics, drug testing laboratories and other entities associated with chiropractor Daniel McCollum have had default judgments entered against them ordering the payment of $140 million.  The defendant entities, Oaktree Medical Centre P.C., FirstChoice Healthcare P.C., Labsource LLC, Pain Management Associates entities, ProLab LLC, and ProCare Counseling Center LLC, were alleged to have provided illegal financial incentives to providers to induce their referrals of urine drug tests in violation of the Stark Law and the Anti-Kickback Statute, and to have submitted false claims to federal healthcare programs for medically unnecessary urine drug testing, steroid injections, opioid prescriptions, and lidocaine ointment prescriptions.  The settlement resolves claims against the entities brought in three separate qui tam actions Donna Rauch, Muriel Calhoun, Brandy Knight, Karen Mathewson and Tracy Hawkins, former employees of pain management clinics owned or operated by McCollum. The government continues to pursue claims against McCollum.  DOJ; USAO SC; November, 2021 judgment against McCollum

Catch of the Week: Florida Lab Owner Pleads Guilty to $73 Million Telemedicine Fraud Scheme

Posted  09/3/21
telemedicine doctor on computer with patient
Editor’s Note: For this week’s biggest story, the record $90 million settlement secured by a Constantine Cannon client against Sutter Health, read more here.
Healthcare fraudsters have a track record of exploiting health crises for personal gain. The COVID-19 pandemic created new telemedicine opportunities for patients to receive care without having to see doctors in person. As expected, fraudsters seized on...
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