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Jul 16, 2021 by |

San Francisco Whistleblower Attorney: False Claims And Anti-Kickback Statute Case Against Nursing Home Chain

ATTORNEY NEWSLETTER

Allegations of Illegal Kickbacks To Physicians

Illegal Referrals To Nursing Homes Alleged

Former Executive Brings Suit

The False Claims Act (FCA), 31 U.S.C. §§ 3729 et seq., allows private citizens with information of fraud against the federal government to bring cases (known as qui tam actions) against businesses defrauding the government in order to recoup the funds lost to fraud.  If the government recovers from the offending business, the plaintiff (known as a “relator”) is eligible for a reward.  31 U.S.C. § 3730(d).  Sometimes the relator alleges violations of more than one federal statute in these cases.  For example, related to the FCA  is the Anti-Kickback Statute, 42 U.S.C. § 1320a-7b, which prohibits offering, soliciting, or receiving any remuneration to induce drug prescriptions, or referrals for nursing home care, medical services or medical or surgical procedures.  Illegal kickbacks for inducements or referrals are only one form of healthcare fraud actionable under the FCA; other types of fraud include overbilling, selling unapproved drugs or medical devices, false certifications and eligibility records or billing for services that were never provided.  If you have credible information of illegal kickbacks or other healthcare fraud in San Francisco or elsewhere in California, call us today at (415)441-8669 and we can help. Our toll-free number is 1-888-50EVANS (888-503-8267).

Illegal Kickbacks Alleged Against Nursing Home Chain

The U.S. Department of Justice recently intervened in a whistleblower qui tam action against a nursing home chain for alleged false claims.[1] The United States alleges that defendants entered into medical directorship agreements with certain physicians that purported to provide compensation for administrative services, but in reality, were vehicles for the payment of kickbacks to induce the physicians to refer patients to the chin’s nursing homes. The Anti-Kickback Statute prohibits offering or paying anything of value to encourage the referral of items or services covered by federal health care programs.  Specifically, the United States alleges that defendants hired certain physicians who promised in advance to refer a large number of patients to the nursing homes, paid physicians in proportion to the number of expected referrals, and terminated physicians who did not refer enough patients. “Illegal financial arrangements with physicians can improperly influence the type and amount of health care that is provided to patients,” said Acting Assistant Attorney General Brian M. Boynton of the Justice Department’s Civil Division. “The department is committed to redressing the corrupting influence of kickbacks on the medical decision‑making of providers participating in federal health care programs.”

“The payment of kickbacks to physicians for referrals turns patients into commodities that can be traded,” said Acting U.S. Attorney Tracy L. Wilkison for the Central District of California. “Profits should not dictate medical decisions, which is why it is illegal to pay for referrals that can cloud physicians’ medical judgment.”

Former Executive Will Receive Reward

If the government ultimately recovers from defendants the whistleblower/relator will be eligible for a reward.  But qui tam cases such as the reported case take a long time.  The complaint was originally filed in 2015 and the case is ongoing.  Evans Law Firm, Inc. has a current qui tam action that has been litigated for over ten years and is not yet resolved. Employer retaliation for bringing these suits is unlawful. Employees, agents, executives, officers, and others are protected from employer retaliation for bringing any false claims qui tam cases. 31 U.S.C. § 3730(h).  If you are fired because you brought any fraud to light, you can fight back under the False Claims Act which prohibits retaliation against you for exposing the wrongdoing.  You may be entitled to sue your employer in court 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). Evans Law Firm, Inc. 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 fraud against Medicare or Medi-Cal or other government programs call Ingrid M. Evans at (415) 441-8669, or toll-free at 1-888-50EVANS (888-503-8267) or by email at <a href=”mailto:info@evanslaw.com”>info@evanslaw.com</a>.  In addition to FCA and CFCA whistleblower cases, Ingrid and Evans Law Firm, Inc. 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. is not involved in the case in any way. The qui tam case is captioned U.S. ex rel. Trilochan Singh v. Paksn, Inc., et al., No. 15-cv-09064 (C.D. Cal.)

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