Catch of the Week -- William Beaumont Hospital
Posted 08/3/18
Anti-Kickback and Stark
This archive displays posts tagged as relevant to the Anti-Kickback Statute and Stark Law.
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August 2, 2018
William Beaumont Hospital will pay $82.74 million to the federal government and $1.76 million to the state of Michigan to settle allegations made by four separate whistleblowers that between 2004 and 2012 it paid doctors above fair market value and provided them with perks such as free or discounted office space in return for patient referrals. Beaumont also allegedly falsely claimed that a CT radiology center qualified as an outpatient department. Beaumont has now entered into a five-year Corporate Integrity Agreement with the Department of Health and Human Services Office of Inspector General. It is not yet determined how much money the four whistleblowers will receive. DOJJuly 16, 2018
Two additional Southern California surgeons have been indicted in a kickback scheme that is alleged to have generated over a billion dollars in fraudulent claims to federal and California healthcare programs. The two physicians were charged for their roles in receiving kickbacks to refer patients to Pacific Hospital. USAO Central District of CaliforniaJuly 16, 2018
Healthquest, Inc. and its owners have settled FCA allegations for $1.5M. According to the government, the home health care company, paid kickbacks to marketers to induce patient referrals. The company has also entered into a 5 year corporate integrity arrangement. The allegations were first brought by a whistleblower, a former marketer, who will receive $300K. USAO Southern District of FloridaJuly 9, 2018
NY-based Health Quest Systems, Inc. (Health Quest), and its subsidiary hospital Putnam Health Center (Putnam) entered a $14.7 million settlement with DOJ and a $895,427 settlement with New York based on their submission of inflated and otherwise impermissible claims for payment to Medicare and Medicaid. Specifically, the defendants billed Medicare for undocumented E&M services, billed for home-health services without supporting medical records, and billed for orthopedic surgeons who referred patients in violation of the Physician Self-Referral Law, also known as the Stark Law. Three former Health Quest employees, who filed suit under the qui tam provisions of the False Claims Act, will receive a share of the recovery, including a reward of nearly $2 million to one of the relators. DOJ; USAO NDNYCatch of the Week -- Health Quest Systems and Putnam Hospital Center
Posted 07/13/18
This week, DOJ announced a $14.7 million settlement with NY-based Health Quest Systems, Inc. (Health Quest), and its subsidiary hospital Putnam Health Center (Putnam) based on their submission of inflated and otherwise impermissible claims for payment to Medicare and Medicaid, making Health Quest and Putnam our Catch of the Week.
The settlement resolves allegations stemming from three separate lawsuits bought by...
June 29, 2018
Nermin Awad El-Hadik was sentenced to five years in prison for his role in paying kickbacks to a medical provider. El-Hadik paid more than $5.3 million in a kickback scheme in exchange for referrals of injured employees covered by the Department of Labor Federal Employees’ Compensation Act. El-Hadik was also ordered to pay over $5.3 million in restitution. USAO WDTXJune 13, 2018
Brothers David Nicoll and Scott Nicoll, who held senior positions at New Jersey-based Biodiagnostic Laboratory Services LLC, were sentenced to prison terms for their respective roles in a physician kickback scheme that resulted in over $100 million in blood sample referrals to the diagnostic lab company. To date, 53 defendants have been convicted as a result of the investigation. The now defunct lab company pleaded guilty and was ordered to forfeit all of its assets in June 2016. USAO NJHow Copayment Waivers can Give Rise to a Whistleblower Claim
Posted 06/8/18
What’s not to like about a doctor waiving a patient’s copayment, or a pharmaceutical company offering a prescription drug assistance program? Turns out there are plenty of reasons to be concerned about such activities. And, as a recently announced $24 million settlement with Pfizer illustrates, unlawful patient cost waivers can result in big liability for defendants.
Patient cost-sharing is a core principle...