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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 11, 2015

Acting New Jersey Attorney General John J. Hoffman announced guilty plea of Rehan Zuberi and his wife Humara Paracha to charges they bribed dozens of doctors in exchange for referrals, worth several million dollars, to the medical imaging centers they owned and operated under the umbrella group Diagnostic Imaging Affiliates which managed numerous diagnostic imaging facilities throughout northern and central New Jersey. NJ

May 8, 2015

New York Attorney General Eric T. Schneiderman announced an agreement in principle to settle kickback claims against Medco Health Solutions subsidiary Accredo Health Group, Inc. to resolve allegations that Accredo recommended the drug Exjade to Medicaid patients in exchange for kickbacks from Novartis Pharmaceuticals Corporation which markets the drug. Under the settlement, Accredo will pay $60 million to the federal government, New York, and several other states. About $3.4 million of the settlement will resolve claims relating to New York’s Medicaid program. In January 2014, another pharmacy, BioScrip, Inc., agreed to pay $15 million to resolve similar claims. The case against Novartis is ongoing. NY

March 16, 2015

New York Attorney General Eric T. Schneiderman announced that New York along with 49 other states and the District of Columbia have reached a settlement with global pharmaceutical company Daiichi Sankyo, Inc. to resolves allegations that Daiichi violated the False Claims Act by using lavish meals and speaker programs to improperly induce physicians to prescribe the drugs Azor, Benicar, Tribenzor and Welchol. Under the agreement, Daiichi agreed to pay the US and state Medicaid programs $39 million. The allegations originated in a whistleblower lawsuit filed by former Daiichi sales representative Kathy Fragoules under the qui tam provisions of the federal and New York State False Claims Acts. She will receive $6.1 million of the federal recovery and an undisclosed portion of the state recoveries. NY

Seventh Circuit Gives Broad Read To What Constitutes A "Referral" Under Anti-Kickback Statute

Posted  02/26/15
By Gordon Schnell
Healthcare Fraud
Under the Anti-Kickback Statute, physicians may not solicit or receive kickbacks for referring Medicare patients to a particular healthcare provider. The question before the Seventh Circuit in United States v. Patel was the scope of what constitutes a referral under the statute. According to the Court, the scope is quite broad, even extending to situations where the physician plays no role in selecting the healthcare...

January 20, 2015

Massachusetts Attorney General Martha Coakley announced South Shore Physician Hospital Organization will pay $1.77M to settle allegations of operating a recruitment grant program through which it paid kickbacks to its physician members in exchange for patient referrals. MA

January 7, 2015

Florida Attorney General Pam Bondi announced that Florida, along with California, Colorado, Kentucky, and Ohio and the federal government, entered a $22 million national settlement with DaVita Healthcare Partners, Inc., one of the leading providers of dialysis services in the US. The settlement resolves allegations originating in a whistleblower lawsuit that DaVita paid illegal kickbacks to induce the referral of patients to its dialysis clinics, causing false claims to be submitted to the Medicaid program. DaVita will pay Florida $5.6 million in restitution and other recoveries. FL

DOJ Reports Continued Surge in False Claims Act Recoveries Prompted by Whistleblowers

Posted  11/21/14
By the C|C Whistleblower Lawyer Team Yesterday, the Department of Justice reported its recovery of a record $5.69 billion in False Claims Act settlements and judgments during the 2014 fiscal year (ending September 30). It is the first time DOJ has crossed the $5 billion mark and brings to $22.75 billion the total False Claims Act recoveries DOJ has obtained since January 2009. That 6-year tally represents more than...

DaVita — Medicare Fraud/Kickbacks ($400 million).

Two of our whistleblower attorneys led the representation of David Barbetta, a former financial analyst for DaVita HealthCare Partners, one of the largest providers of dialysis services in the United States. Mr. Barbetta brought a qui tam action under the False Claims Act against DaVita alleging the company violated the Anti-Kickback Statute by paying physicians to refer their patients to DaVita clinics for dialysis. According to the complaint, DaVita sold doctors shares of DaVita clinics at below fair market value, and purchased doctors’ interests in other clinics at above fair market value. The government joined the case, and alleged that DaVita had entered into these sweetheart deals with doctors, which gave the doctors returns of over 100%, and the doctors then steered their patients to DaVita clinics. In 2014, DaVita paid $400 million to settle the case, the largest stand-alone kickback settlement to date. See Denver Post and Modern Healthcare for more.

October 22, 2014

DaVita Healthcare Partners, Inc., one of the leading providers of dialysis services in the United States, agreed to pay $400 million to resolve claims it violated the False Claims Act by paying kickbacks for patient referrals to its dialysis clinics through its use of a sophisticated three-part joint venture business model to induce patient referrals to its clinics..  David Barbetta, former Senior Financial Analyst for DaVita, will receive an undisclosed whistleblower award. DOJ

TAF Whistleblower of the Year -- Halifax Whistleblower Elin Baklid-Kunz

Posted  09/18/14
By the C|C Whistleblower Lawyer Team The whistleblower advocacy and education group Taxpayers Against Fraud (TAF) just had their fourteenth annual conference in Washington. And in what has become a highlight of the three-day event, the organization made its annual Whistleblower of the Year award. This year's winner is Elin Baklid-Kunz. She is the long-time employee of Halifax Health Medical Center who exposed the...
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