ATTORNEY NEWSLETTER
Illegal Physician Referral Kickbacks
Violations of Stark Law and False Claims Act
Former Billing Manager Blows Whistle
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 kind 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).
Stark Law Case Example
In a recent example of Stark Law whistleblower allegations,[1] s complaint has been unsealed against the president, chief financial officer and co-owner of an imaging clinic, including allegations off violation of the Stark Law and False Claims Act. The complaint alleges that defendant orchestrated a scheme where his clinic paid exorbitant fees, above fair market value, to doctors who referred patients for cardiac positron emission tomography (PET) scans. According to the complaint, the alleged conduct is in violation of the Stark Law, which prohibits healthcare providers from billing Medicare for certain services referred by a physician with whom the provider has a financial relationship. The Stark Law was enacted to protect patients from financial arrangements that could negatively impact physicians’ decision-making and lead to unnecessary services. Knowingly submitting claims to Medicare in violation of the Stark Law also violates the federal False Claims Act.
U.S. Attorney Alamdar S. Hamdani stated, “Improper compensation arrangements unnecessarily drive-up healthcare costs and cloud a physician’s medical judgment. This complaint alleges that in an effort to increase profits, [defendant] caused [his clinic] to enter into improper compensation arrangements with cardiologists who referred patients for cardiac PET scans. We are committed to enforcing the Stark Law and protecting government healthcare programs from these types of improper financial relationships.”
Building a Whistleblower Case
The whistleblower in the reported case was a former billing manager at defendant’s imaging clinic. 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).
Contact Us
Ingrid M. Evans and the other whistleblower litigators at Evans Law Firm handle cases involving violations of the Stark Law, other false claims or kickback schemes involving government contracts, 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.
