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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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May 29, 2018

Following a two-week jury trial, LaTonya Mallory, Floyd Calhoun Dent III, and Robert Bradford Johnson were collectively found liable for $114 million for violating the False Claims Act and Anti-Kickback Statute by paying physicians for patient referrals to two blood-testing laboratories, and for causing those laboratories to bill federal health care programs for medically unnecessary testing. The verdict resolves three separate whistleblower suits filed by Dr. Michael Mayes, Scarlett Lutz, Kayla Webster, and Chris Reidel, who will receive a yet-to-be-determined share of any recoveries. USAO DDC

May 24, 2018

Pharmaceutical giant Pfizer agreed to pay $23.85 million and enter in to a corporate integrity agreement to resolve claims under the False Claims Act that it induced Medicare patients to use three Pfizer drugs, Sutent, Ilyta, and Tikosyn, by unlawfully covering patients copays in violation of the AKS; in doing so, Pfizer increased its profits and masked the effect of drug price increases. DOJ

May 17, 2018

Five New Jersey salesmen were sentenced to prison terms ranging from 21 to 41 months for their role in violating the AKS and other laws by bribing doctors-with cash, sham consulting fees, and other means of payment-for patient blood specimen referrals. USAO DNJ

May 17, 2018

New Orleans physician Jobie Crear was sentenced to 8 months in prison and ordered to pay more than $810,000 to Medicare for his role in an illegal kickback conspiracy in which he paid recruiters to bring Medicare patients to a nursing and home health services company he operated. USAO EDLA

US Obtains $114M FCA Judgement in Kickbacks Case

Posted  05/31/18
On May 23, the US District Court in South Carolina issued judgment for the US for roughly $114M against three individuals, LaTonya Mallory, Floyd Dent III, and Robert Johnson, for violating the FCA by paying kickbacks to doctors in exchange for patient referrals. The defendants also caused two labs to bill Medicare, TRICARE, and Medicaid for medically unnecessary tests. The judgment follows a January jury verdict that...

Pfizer Agrees to Pay $23.85 Million to Resolve False Claims Act Liability for Paying Kickbacks

Posted  05/24/18
The Department of Justice today announced that Pfizer agreed to pay $23.85 million to resolve allegations that it used a foundation as a conduit to pay the copays of Medicare patients taking three Pfizer drugs. Medicare Part B or D beneficiaries typically make a partial payment when obtaining prescription drugs in the form of a copay, coinsurance, or deductible. Under the Anti-Kickback Statute, pharmaceutical...

Michigan Home Health Agency Owner Pleads Guilty to Health Care Fraud Charges

Posted  05/18/18
The owner of a Michigan home health agency pleaded guilty to fraud charges for his role in a scheme involving approximately $8 million in fraudulent Medicare claims for home health services that were procured through the payment of illegal kickbacks. Zahir Shah, 48, of West Bloomfield, Michigan, pleaded guilty to one count of conspiracy to commit health care fraud and wire fraud and one count of conspiracy to pay and...

May 10, 2018

Cincinnati-based non-profit Mercy Health, which operates healthcare facilities in Ohio and Kentucky, agreed to pay $14,250,000 to settle allegations that it violated the False Claims Act and Stark Law by engaging in improper financial relationships with referring physicians. Specifically, the government alleged that Mercy Health provided compensation to six employed physicians that exceeded the fair market value of their services. DOJ

May 7, 2018

Dr. Robert Fetchero, Dr. Sridhar Pinnamaneni, and Dr. Thelma Green-Mack agreed respectively to pay $200,000, $370,000 and $130,000 to settle allegations that they violated the False Claims Act, Anti-Kickback Statute, and the Stark Law by receiving improper payments for referrals from Pennsylvania-based drug testing lab Universal Oral Fluid Laboratories. According to the government, these physicians referred Medicare patients to Universal for drug testing services while engaged in a financial relationship with the lab. (DOJ (WDPA)

April 26, 2018

Tennessee physician Brenna Green paid roughly $200,000 to settle claims she violated the False Claims Act, the Stark Law and the Anti-Kickback Statute for her role in a kickback scheme with Southwest Laboratories, Medscan Laboratory, and sales representatives affiliated with Southwest and Medscan. According to the government, Green acquired shares in Southwest for a nominal sum in exchange for a guaranteed “dividend” of approximately $5,000 per month as long as she met or exceeded the number of urine drug screen referrals required by Southwest. DOJ (NDVA)
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