ATTORNEY NEWSLETTER
Illegal Inducements Allegedly Paid To Suppliers
Free Data Aided Suppliers In Marketing To Physicians
Former Employee to Receive $4.3 Million For Blowing Whistle
The Anti-Kickback Statute, 42 U.S.C. § 1320a-7b (prohibits kickbacks for medical services referrals), and the Stark Law, 42 U.S.C. § 1395nn (prohibits physicians from referring patients to providers that the physician has a financial interest in) are federal laws designed to ensure doctors make medical decisions with only their patients’ best interests in mind. The statutes prohibit kickbacks or lucrative referral programs which create monetary incentives that may be opposed to a patient’s best interest. When the kickback relates to a medical service or product paid for by the government (under Medicare or Medicaid, for example) the federal payment is fraudulent because the kickback/referral statutes have been violated. Private citizens can bring civil lawsuits on behalf of the government for redress against such fraud under the False Claims Act, (“FCA”), 31 U.S.C. § 3729 et seq. If you have credible information of fraud against the government in violation of the FCA, Anti-Kickback Statute or Stark Law 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).
Recent False Claims Act/Anti-Kickback Statute Case Settlement[1]
In a recent press release by the U.S. Department of Justice (DOJ), a manufacturer of durable medical equipment (DME) has agreed to pay over $24 million to resolve False Claims Act allegations that it misled federal health care programs by paying kickbacks to DME suppliers. The settlement resolves allegations that defendant caused DME suppliers to submit claims for ventilators, oxygen concentrators, CPAP and BiPAP machines, and other respiratory-related medical equipment that were false because defendant provided illegal inducements to the DME suppliers. The company allegedly gave the DME suppliers physician prescribing data free of charge that could assist their marketing efforts to physicians.
“Paying illegal remuneration to induce patient referrals undermines the integrity of our nation’s health care system,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “To ensure that the goods and services received by federal health care program patients are determined by their health care needs, rather than the financial interests of third parties, we will pursue any individual or entity that violates the prohibition on paying kickbacks, including DME manufacturers.”
How A Qui Tam Action Begins
A former employee (referred to as the “relator”) initiated the case just described. Any False Claims Act whistleblower case begins by a relator filing a complaint under seal in the federal court usually for the District in which the 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
If you have credible information of government fraud in San Francisco or elsewhere in California, 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. was not involved in the case in any way. The qui tam case is captioned United States ex rel. Respiratory Care, LLC v. Respironics, Inc., et al., Case No. 2:19-cv-02913-BHH (D.S.C.).
