Anti-Kickback and Stark
This archive displays posts tagged as relevant to the Anti-Kickback Statute and Stark Law.
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November 20, 2018
Gray Wesley Barrow, a doctor and co-owner of Louisiana Spine & Sports LLC, a pain management clinic in Baton Rouge, has pleaded guilty to receiving approximately $336,000 in unlawful kickbacks. According to the plea, between 2014 and 2016 Barrow sent urine specimens collected from his patients to a drug testing laboratory that agreed to pay him a percentage of the reimbursements paid to the laboratory by health care benefit programs including Medicare. DOJ; USAO M.D. La.November 14, 2018
After pleading guilty last year, the owner of two health clinics in Detroit has been sentenced to 160 months in prison and ordered to pay over $6 million for defrauding Medicare. Along with multiple co-defendants, Jacklyn Price allegedly took part in a scheme to bill Medicare for services that were obtained through kickbacks, not medically necessary, not actually provided, or provided by an unlicensed practitioner. Her co-defendants, Millicent Traylor, Muhammad Qazi, and Christina Kimbrough, were all sentenced in September. DOJNovember 5, 2018
A Michigan-based patient recruiter for home health care agencies was convicted, following trial, for her role in a scheme to bill Medicare for claims arising from illegal kickbacks. Together with co-conspiring home healthcare agencies, Sophia Eggleston defrauded Medicare of $1.1 million. The scheme, which was active for at least three years, involved Eggleston soliciting and receiving kickbacks in exchange for patient referrals to co-conspirator home health agency contacts, who then submitted Medicare claims for services purportedly provided to the referred patients. Eggleston faces sentencing in February. DOJOctober 26, 2018
Abbott Laboratories and AbbVie, Inc. have agreed to pay $25 million to settle a case initiated by a whistleblower alleging that the pharma companies paid unlawful kickbacks and engaged in unlawful off-label marketing for the drug TriCor. The kickbacks took the form of gifts and payments for consulting and speaking engagements that were meant to induce or reward physicians for prescribing TriCor. The off-label marketing consisted of Abbott's advertising the drug for conditions for which it was not FDA-approved. The whistleblower, Amy Bergman, a former Abbott sales representative, will receive $6.5 million of the settlement. USAO E.D.Pa.October 18, 2018
Four individuals have pleaded guilty to conspiring to violate the Anti-Kickback Statute for a scheme that made payments to patient recruiters and a medical office assistant to find TRICARE beneficiaries to get prescriptions for compounded prescription pain cream, scar cream, and supplements from a doctor who had never seen the patients. In less than one year, the scheme generated over $10 million in compound prescriptions for over 100 TRICARE beneficiaries. E.D. Ark.October 9, 2018
The former CFO and COO of Houston-area Atrium Medical Center and Pristine Healthcare, Starsky Bomer, has been convicted for his role in a $16 million Medicare kickback scheme. Bomer and others paid illegal kickbacks to group home owners and patient recruiters in exchange for the referral of Medicare patients for outpatient mental health treatment through the hospitals' partial hospitalization program (PHP). While the hospitals billed Medicare $16 million for these patients, the evidence at trial demonstrated that Bomer knew that PHP services were not necessary for most of the patients, and that the patients were not, in fact, provided with such services. DOJSeptember 28, 2018
Kalispell Regional Healthcare System and six of its related entities agreed to pay $24 million to settle a False Claims Act case based on its compensation arrangements with physicians, which were alleged to violate the Stark Law, and other arrangements alleged to violate the Anti-Kickback Statute. Between 2010 and 2018, KRH entities reportedly paid excessive and above-market full-time compensation to more than 60 physicians, even if those physicians worked far less than full-time. In addition, some of the KRH entities were alleged to unlawfully seek referrals from physicians through excessive compensation arrangements and the provision of administrative services at below market rates. Jon Mohatt, the former CFO of a related entity, initiated the action with a qui tam filing; Mohatt will receive $5.4 million dollars as a relator's share of the government's recovery. DOJCatch of the Week — Health Management Associates
Posted 09/27/18
