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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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Page 35 of 60

March 30, 2018

Larry B. Howard, the owner of an Orlando-based Fertility Pharmacy, was sentenced to serve 160 months in prison and forfeit over $4.3 million for his role in a kickback scheme involving pain and scar creams that resulted in the payment of approximately $4.3 million in false and fraudulent claims to TRICARE. DOJ

Tagged in: Anti-Kickback and Stark, Compounding Pharmacy Fraud, Other Government Health Programs,

March 29, 2018

Juan Yrorita, the assistant director of nursing at Detroit area home health agency Annointed Care Services, was sentenced to 36 months in prison and pay and forfeit roughly $50 million for his role in a scheme involving approximately $1.6 million in fraudulent Medicare claims for home health services that were procured through the payment of kickbacks, and that were medically unnecessary and not provided. DOJ

Tagged in: Anti-Kickback and Stark, Home Health and Hospice, Lack of Medical Necessity,

March 29, 2018

Georgia Bone & Joint, Southern Bone & Joint (a/k/a Summit Orthopaedic Surgery Center), Southern Crescent Anesthesiology, PC, Sentry Anesthesia Management, LLC, and David LaGuardia agreed to pay $3.2 million to settle claims they violated the False Claims Act and Anti-Kickback Statute. Specifically, the government alleged that LaGuardia, Sentry, and Southern Crescent provided a free medical director to Summit Surgery Center to induce it to choose to perform more procedures at the surgery center rather than in the Georgia Bone office. The government further alleged that Georgia Bone and LaGuardia caused the submission of false claims to Medicare for prescription drugs purchased outside the United States and not approved by the FDA. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Sharon Kopko, former Practice Administrator for Southern Bone. She will receive a yet-to-be determined award from the proceeds of the government’s recovery. DOJ (NDGA)

Tagged in: Anti-Kickback and Stark, FCA Federal, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

March 29, 2018

Texas-based SightLine Health LLC, which operates radiation therapy centers throughout the United States, agreed (together with its parent Oncology Network Holdings) to pay up to $11.5 million settle claims  it violated the False Claims Act and Anti‑Kickback Statute. According to the government, SightLine targeted physicians that were able to refer patients to its cancer treatment centers, and paid those physicians a share of its profits. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act. The whistleblower will receive an award of up to $1.725 million from the proceeds of the government’s recovery. DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

March 8, 2018

Massachusett’s-based Abiomed, Inc. agreed to pay $3.1 million to settle claims of violating the False Claims Act and Anti-Kickback Statute by purchasing lavish meals for physicians in order to induce them to use Abiomed’s Impella line of heart pumps. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by a former Abiomed employee. The whistleblower will receive an award of $542,500 from the proceeds of the government’s recovery. DOJ (MA)

Tagged in: Anti-Kickback and Stark, FCA Federal, Medical Devices and DME, Whistleblower Case, Whistleblower Rewards,

March 7, 2018

UPMC Hamot, affiliated with the University of Pittsburgh Medical Center, and Medicor Associates Inc., a regional physician cardiology practice, agreed to pay $20.7 million to settle charges of violating the False Claims Act, Anti‑Kickback Statute and Stark Law through Hamot's payment under twelve physician and administrative services arrangements to secure Medicor patient referrals. Hamot allegedly had no legitimate need for the services contracted for, and in some instances the services either were duplicative or were not performed. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Medicor employee Dr. Tullio Emanuele. He will receive a whistleblower award of roughly $6 million from the proceeds of the government's recovery. DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Hospital Fraud, Lack of Medical Necessity, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

March 6, 2018

Iowa chiropractor Bradley Brown and his clinic Brown Chiropractic, P.C. agreed to pay roughly $80,000 to settle claims they violated the False Claims Act and Anti-Kickback Statute by billing Medicare and Medicaid for chiropractic adjustments after providing free electrical stimulation to beneficiaries to influence those beneficiaries to receive chiropractic adjustments from Brown. DOJ (NDIA)

Tagged in: Anti-Kickback and Stark, Chiropractic, FCA Federal, Healthcare Fraud, Provider Fraud,

February 28, 2018

Rafael Arias, the owner of numerous Miami-area home health agencies, was sentenced to 240 months in prison and pay $66.4 million in restitution for his role in a $66 million conspiracy to defraud the Medicare program. As part of his guilty plea, Arias admitted recruiting nominee owners to falsely and fraudulently represent themselves as the agencies’ owners to hide his identity and ownership interest. Arias and his co-conspirators paid illegal bribes and kickbacks to patient recruiters to refer patients to these agencies, and submitted false and fraudulent home health care claims to Medicare for beneficiaries who, in many cases, did not qualify or for whom the services were never provided. DOJ

Tagged in: Anti-Kickback and Stark, Healthcare Fraud, Home Health and Hospice,

February 22, 2018

Samuel Konell was sentenced to 60 months in prison and pay roughly $10 million for his role in a $63 million health care fraud scheme involving now-defunct Greater Miami Behavioral Healthcare Center Inc. which purported to provide partial hospitalization program (PHP) services to individuals suffering from mental illness. Konell admitted he received kickbacks and/or bribes in return for referring Medicare beneficiaries from the Miami-Dade state court system to Greater Miami to serve as patients. He admitted he coordinated with criminal defendants in the state court system to obtain court orders for mental health treatment in lieu of incarceration so that he could refer those individuals to Greater Miami to serve as patients in return for kickbacks and/or bribes. Konell further admitted that he did so knowing that certain of those individuals were not mentally ill or otherwise did not meet the criteria for PHP treatment. DOJ

Tagged in: Anti-Kickback and Stark, Lack of Medical Necessity, Provider Fraud,

February 13, 2018

Detroit-area doctor Mahmoud Rahim was sentenced to 72 months in prison and ordered to forfeit roughly $1.7 million for his role in a $10.4 million conspiracy to defraud the Medicare program. According to the evidence presented at trial, Rahim accepted kickbacks in exchange for referring Medicare patients for electromyogram tests, some of which were unnecessary, and physical therapy performed by unlicensed individuals. DOJ

Tagged in: Anti-Kickback and Stark, Improper Medical Personnel, Lack of Medical Necessity, Provider Fraud,

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