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Mar 9, 2021 by |

Los Angeles County and California Whistleblower Attorney: Health Records Vendor Reaches $18.26 Million Settlement to Resolve Kickback Allegations

ATTORNEY NEWSLETTER

Allegations of Unlawful Kickbacks

Free Trips to Golf Tournaments and the Kentucky Derby

Whistleblowers Will Receive Share of Settlement

In order to protect all of us from medical services or care procured by health care providers paying kickbacks for referrals, federal law prohibits such conduct.  See Anti-Kickback Statute, 42 U.S.C. § 1320a-7b. When the services procured by kickbacks are paid for by government programs, the conduct also constitutes a violation of federal and perhaps State false claims act.   See federal False Claims Act (FCA), 31 U.S.C. §§ 3729 et seq. and the California False Claims Act (CFCA), Cal. Gov’t Code §§ 12650 et seq.  Illegal kickbacks are only one form of healthcare fraud actionable under the FCA and CFCA; other types of fraud include overbilling, selling unapprove4d drugs or medical devices, false certifications and eligibility records or billing for services that were never provided.  Much of this fraud is committed against government programs like Medicare and here in California Medi-Cal. Individuals with knowledge of illegal kickbacks can be rewarded for bringing suit against the offending companies who defraud these programs.  The suit is initiated by filing complaints known as “qui tam” complaints..  31 U.S.C. § 3730(b)(federal); Cal. Gov’t Code § 12652(c)(1)(California).  If you have credible information of illegal kickbacks or other healthcare fraud here in Los Angeles County or elsewhere in California, call us today at (415)441-8669 and we can help.

Allegations of Illegal Kickbacks

In a recent settlement of two related cases,[1] a medical records provider allegedly violated the False Claims Act and the Anti-Kickback Statute through its marketing programs. First, the provider allegedly invited prospective and existing customers to “Concierge Events,” providing free tickets to and amenities at sporting, entertainment, and recreational events, including trips to the Masters Tournament and the Kentucky Derby with complimentary travel and luxury accommodations, meals, and alcohol. Second, defendant allegedly paid kickbacks to its existing customers of amounts up to $3,000 for each new client that signed up for services after the existing customer spent speaking to or meeting with the new client. Finally, defendant allegedly entered into deals with competing vendors where it paid its competitors based on the value of services the competitor had been providing while in fact using less expensive recycled, refurbished, reconditioned, and/or reconfigured parts to perform the contracts once defendant was hired. The government found all of this conduct unacceptable. “We expect companies that seek to do business with the government to provide complete and accurate information so contract prices can be negotiated on a level playing field,” said Acting Assistant Attorney General of the Justice Department’s Civil Division Jeffrey Bossert Clark.  

“It is illegal for companies to extend invitations to all-expense-paid sporting, entertainment, and recreational events, and other perk-filled offers to its prospective customers to win business and boost their bottom line through illegal kickback schemes,” said Joseph R. Bonavolonta, Special Agent in Charge of the FBI Boston Division. “Today’s agreement by Athena to pay $18.25 million should send a strong message to anyone thinking about engaging in this type of illegal activity. The FBI will continue to work with our law enforcement partners to do everything in our power to safeguard our government health care programs and the taxpayers picking up the bill.”

Three Individuals To Share Reward

The two related cases were brought by a total of three individuals who will share a percentage of the $18.26 million settlement as a reward.  While these whistleblowers were not current employees of the defendant provider, currently employed individuals are protected from employer retaliation for bringing false claims qui tam cases. 31 U.S.C. § 3730(h)(federal anti-retaliation protection); Cal. Gov’t Code § 12653(employee anti-retaliation protection under California law).  If you are fired because you brought any fraud to light, you can fight back under both the federal and State statutes.  You may be entitled to sue your employer in federal or State court (usually where your underlying qui tam case is filed) and seek double back pay (with interest), reinstatement, reasonable attorneys’ fees, and reimbursement for certain costs in connection with the litigation. 31 U.S.C. § 3730(h)(2) (federal); Cal. Gov’t Code § 12653(b)(California). Our whistleblower attorneys can represent you in any action for retaliation as well as represent you in your underlying whistleblower application.

Contact Us

If you have credible information of government contractor fraud against the federal government or the State of California, like overcharging or use of substandard goods, call Ingrid M. Evans and our other Los Angeles County whistleblower attorneys at (415) 441-8669, or by email at <a href=”mailto:info@evanslaw.com”>info@evanslaw.com</a>.  In addition to FCA and CFCA whistleblower cases, we also handle bank fraud whistleblower cases under FIRREA/FIAFEA, commodity trading and securities fraud under the Commodities Futures Trading Commission Whistleblower Program and the Securities and Exchange Commission Whistleblower Program, and tax fraud under the Internal Revenue Service Whistleblower Program. 

[1] Evans Law Firm, Inc. was not involved in these cases in any way. The two lawsuits are captioned United States ex rel. Sanborn. v. athenahealth, Inc., No. 17-cv-12125 (D. Mass.) and United States ex rel. Lovell and McKusick v. athenahealth, Inc., No. 17-cv-12543 (D. Mass.). The claims resolved by the settlement are allegations only and there has been no determination of liability

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