ATTORNEY NEWSLETTER
Alleged Violations of Anti-Kickback Statute And False Claims Act
$6 Million Settlement
Whistleblower Will Receive $1.1 Million Reward
Kickbacks to physicians for patient referrals are illegal, whether the referral is to a clinic, hospital, lab, nursing home, hospice program or any other health care provider. When the patients are covered by Medicare or other government payment programs, these kickbacks also constitute fraud against the government. These kinds of kickback schemes violate three primary federal statutes: the Anti-Kickback Statute (42 U.S.C. § 1320a-7b), the Stark Law (42 U.S.C. § 1395nn), and the False Claims Act (31 U.S.C. §§ 3729 et seq.). The whistleblower attorneys at Evans Law Firm, Inc. represent individuals with credible information of healthcare fraud under the Anti-Kickback Statute, Stark Law and similar statutes. If you have credible information for a whistleblower or qui tam case, call us. today at (415) 441-8669 or toll free at (888)50-EVANS(503-8267).
Recent Settlement
As an example of settlement of whistleblower allegations of illegal kickbacks,[1] the Justice Department recently announced that five ophthalmology practices have agreed to pay a total of nearly $6 million to resolve alleged violations of the False Claims Act arising from their billing for trans-cranial doppler ultrasounds (TCDs) through a kickback arrangement with a third-party testing company. All five practices have agreed to cooperate with the Justice Department’s ongoing investigations of other participants in the alleged scheme.
“Kickbacks and false claims increase healthcare costs for all Americans and undermine the integrity of healthcare decision-making,” said Assistant Attorney General Brett A. Shumate of the Justice Department’s Civil Division. “Combatting such schemes will continue to be a priority for the Justice Department.”
The settlements resolve allegations that the settling practices knowingly submitted, and caused the submission of, false claims to Medicare and Medicaid for medically unnecessary TCDs. The settling practices performed TCDs on thousands of patients and billed Medicare and Medicaid hundreds of dollars per test. The settling practices paid the third-party testing company based on the volume or value of tests ordered and referred the patients to the testing company’s preferred radiology group for the TCDs’ professional component.
The civil settlements resolved claims in a lawsuit filed under the qui tam or whistleblower provision of the False Claims Act, which permits private parties to file suit on behalf of the United States for false claims and share in a portion of the Government’s recovery. The qui tam was filed by a whistleblower who will receive $1,135,250 in connection with the settlements.
Whistleblower Case Procedures And Rewards
Any False Claims Act whistleblower case begins by a relator filing a complaint under seal in the federal court usually for the United States District Court for the district where defendant is located or does business. At the same time, the relator submits a disclosure to the DOJ outlining the material evidence the relator has of the alleged false claims. 31 U.S.C. § 3730(b). The seal period of the complaint lasts 60 days during which the DOJ investigates the claims. 31 U.S.C. § 3730(b)(2). (If necessary, the government can, and often does, extend the 60-day period during which the allegations are kept under seal.) If the government decides to intervene in the case, the government essentially takes over the litigation. 31 U.S.C. § 3730(c)(1). If the government declines to intervene, the relator may proceed with the litigation on his or her own. 31 U.S.C. § 3730(c)(3). The whistleblower in the case discussed above will receive a share of the $3.3 million settlement.
Contact Us
Ingrid M. Evans and the other whistleblower litigators at Evans Law Firm handle cases involving false claims or kickback schemes, or cases under the Internal Revenue Code for prosecution of tax avoidance schemes including offshore tax avoidance schemes. Contact Ingrid M. Evans and the other California whistleblower attorneys at Evans Law Firm, Inc. at (415) 441-8669, toll free at (888)50-EVANS(503-8267) or by email at <a href=”mailto:info@evanslaw.com”>info@evanslaw.com</a>. Our lawyers also handle cases under the federal or California False Claims Acts, the Financial Institutions Reform, Recovery and Enforcement Act of 1989 (FIRREA), the Bank Secrecy Act, the Internal Revenue Service Whistleblower Office, the Commodity Futures Trading Commission Whistleblower Office, the FINRA Whistleblower Office or other government agency whistleblower programs.
[1] Evans Law Firm, Inc. was not involved in the case in any way. The settlement was announced in a press release by the U.S. Department of Justice.
