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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 53 of 60

May 1, 2015

Accredo Health Group, a unit of Express Scripts Holding Co., agreed to pay $60 million to settle False Claims Act and Anti-Kickback Statute charges that the company participated in a kickback scheme with Novartis Pharmaceuticals Corp. involving the prescription drug Exjade.  According to the government, Novartis provided kickbacks, in the form of patient referrals and related benefits, to Accredo in exchange for Accredo recommending refills to Exjade patients.  The government also intervened in a whistleblower lawsuit against Novartis for the same alleged scheme.  The government claims defendants allegedly understated the serious and potentially life-threatening side effects of Exjade when promoting the drug’s benefits to patients. FBI

Tagged in: Anti-Kickback and Stark, FCA Federal, Pharma Fraud,

April 29, 2015

The Hospital Authority of Irwin County (ICH) and several doctors agreed to pay $520,000 to settle charges they violated the False Claims Act, the Anti-Kickback Statute, the Stark Law and related Georgia Medicaid policies in connection with the amount of compensation paid by ICH to one of the doctors, ICH’s leases with the doctors, and the supervision of certain diagnostic imaging services at ICH.  The allegations first arose in a whistleblower lawsuit filed by Connie Brogdon and Summer Holland under the qui tam provisions of the False Claims Act and the Georgia False Medicaid Claims Act.  They will receive an undisclosed portion of the settlement payment.  DOJ

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

April 21, 2015

Family Dermatology P.C., which owns and operates a dermatopathology lab in Georgia and several dermatology practices throughout the Eastern United States, agreed to pay $3,247,835 to settle allegations it violated the False Claims Act and the Stark Statute by engaging in improper financial relationships with a number of its employed physicians.  According to the government, Family Dermatology routinely required its dermatologists to use Family Dermatology’s in-house pathology lab, which operated under the name Nelson Dermatopathology, for their pathology services.  The allegations first arose in three whistleblower lawsuits filed under the qui tam provisions of the False Claims Act by Scott M. Ross MD, Mark F. Baucom and Harold Milstein MD.  They will collectively receive a whistleblower award of more than $584,000.  DOJ

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

April 21, 2015

Texas-based Citizens Medical Center agreed to pay $21,750,000 to settle allegations it violated the False Claims Act and Stark Statute by engaging in improper financial relationships with referring physicians.  According to the government, the hospital provided compensation to several cardiologists that exceeded the fair market value of their services and paid bonuses to emergency room physicians that improperly took into account the value of their cardiology referrals.  The allegations first arose in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Dakshesh “Kumar” Parikh, Harish Chandna and Ajay Gaalla.  They will collectively receive a whistleblower award of $5,981,250.  DOJ

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

April 16, 2015

Felix Gonzalez, owner of Miami home health care company AA Advanced Care Inc. was ordered to pay $21,423,160 in restitution and sentenced to 113 months in prison in connection with a $32 million Medicare fraud scheme.  Gonzalez admitted operating his company for the purpose of billing the Medicare program for expensive physical therapy and home health care services that were not medically necessary or provided at all.  He further admitted he negotiated and paid kickbacks and bribes to patient recruiters in exchange for patient referrals, as well as prescriptions, plans of care (POCs) and certifications for medically unnecessary therapy and home health services.  DOJ

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

April 9, 2015

Virginia-based cardiovascular testing disease laboratory Health Diagnostics Laboratory Inc. agreed to pay $47 million to resolve allegations it violated the False Claims Act by paying kickbacks to physicians in exchange for patient referrals and billing federal health care programs for medically unnecessary testing.  A second cardio testing lab, California-based Singulex Inc., agreed to pay $1.5 million to settle similar charges.  The allegations first arose in a whistleblower lawsuit filed by Dr. Michael Mayes, Scarlett Lutz, Kayla Webster and Chris Reidel under the qui tam provisions of the False Claims Act.  The whistleblower award they will receive has yet to be determined.  Whistleblower Insider

Tagged in: Anti-Kickback and Stark, FCA Federal, Laboratory and IDTF, Lack of Medical Necessity, Whistleblower Case, Whistleblower Rewards,

March 31, 2015

Ohio-based Robinson Health System Inc. agreed to pay $10 million to settle claims it violated the False Claims Act, the Anti-Kickback Statute and the Stark Statute by engaging in improper financial relationships with referring physicians.  DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Hospital Fraud,

March 9, 2015

Florida home health care companies Recovery Home Care Inc., Recovery Home Care Services Inc. and National Home Care Holdings LLC have agreed to pay $1.1 million to resolve allegations that Recovery Home Care violated the False Claims Act by improperly paying doctors for referrals of home health care services provided to Medicare patients.  According to the government, the physicians were over-compensated for any actual work they performed and, in reality, they were paid to induce them to refer their patients to Recovery Home Care in violation of the Anti-Kickback Statute and the Stark Law.  The allegations originated in a whistleblower lawsuit filed by former Recovery Home Care employee Gregory Simony under the qui tam provisions of the False Claims Act.  Simony will receive a whistleblower award of $198,000.  DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Home Health and Hospice, Whistleblower Case, Whistleblower Rewards,

March 2, 2015

Patient safety consultant Dr. Charles Denham and his consulting company Health Care Concepts Inc. and his research organization Texas Medical Institute of Technology agreed to pay $1 million to settle allegations they violated the False Claims Act by soliciting and accepting kickbacks.  According to the government, Denham received monthly payments from CareFusion Corporation while serving as the co-chair of the Safe Practices Committee of the National Quality Forum which reviews, endorses and recommends standardized healthcare performance measures and practices, and Denham received these payments in exchange for recommending, promoting and/or arranging for the purchase of CareFusion’s product, ChloraPrep, in violation of the Federal Anti-Kickback Statute.  DOJ

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

February 23, 2015

Two South Florida medical doctors and their wives, Dr. Alan and Lynn Buhler and Dr. Craig and Cynthia Prokos agreed to pay $1M and $90,000, respectively, to settle allegations they violated the False Claims Act when their wives accepted sham marketer salaries in exchange for their husbands’ referrals to a home health care company called A Plus Home Health Care Inc.  The US previously settled with A Plus and its owner Tracy Nemerofsky and five other couples that allegedly accepted payments from A Plus.  DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Home Health and Hospice,

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