Anti-Kickback Statute Lawyer in Atlanta

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Do you know about a hospital, skilled nursing facility, nursing home or lab that is paying kickbacks to convince doctors to refer patients and medical business? Kickbacks ratchet up healthcare costs for all Americans and they are illegal. Under the False Claims Act, whistleblowers who help the Government recover money are entitled to 15% to 30% of what the Government gets.

Talk to Lee Wallace, an experienced Atlanta anti-kickback attorney at The Wallace Law Firm, LLC to learn more about filing a claim. Attorney Lee Wallace has been named one of the Top 100 Lawyers, Top 50 Women Lawyers, and Top 100 Trial Lawyers. She is experienced in all types of whistleblower claims, including those involving kickbacks.

Discuss filing a whistleblower claim under the False Claims Act today.

You Can Be a Whistleblower Who Fights Kickbacks

The Anti-Kickback statute, 42 U.S.C. §1320a-7b(b)(1), makes it illegal to give or receive something of value in order to convince someone:

  • “(A) to refer an individual to a person for the furnishing or arranging for the furnishing of any item or service for which payment may be made in whole or in part under a Federal health care program, or
  • (B) to purchase, lease, order, or arrange for or recommend purchasing, leasing, or ordering any good, facility, service, or item for which payment may be made in whole or in part under a Federal health care program.”

Congress was very serious about stopping these bribes; someone who violates the statute is guilty of a felony and can face up to 5 years in prison and a $25,000 fine.

Whistleblowers like you can file suit under the False Claims Act to make sure nursing homes and other large medical companies do not generate business by paying kickbacks — which of course ultimately get wrapped back into the cost of healthcare.

Violations of the Anti-Kickback Statute

Below are examples of healthcare companies violating the Anti-Kickback Statute:

  • In 2013, the United States intervened (meaning, chose to become directly involved in) a case brought by a whistleblower against a Fort Lauderdale, Florida, home health company. A Plus Home Health Care, Inc., according to the Government and the whistleblower, who had been the director of development at the home health care company, wanted to convince physicians to refer Medicare patients who needed care home care for their health needs. A Plus Home knew that kickbacks are illegal, so it couldn’t directly pay the physicians to refer the patients. However, the complaint says that the home health company came up with an end run around the restriction: it offered paid “jobs” to the spouses (or, in one case, the boyfriend) of eight doctors. The Government said that the home health company went to great lengths to hide the kickback, and even “generated sham personnel files, which included lists of job duties the spouses and boyfriend did not perform and performance reviews of job functions they did not complete.” You can read more in the Government’s July 2013 press release, U.S. Intervenes in False Claims Act Lawsuit Against Fla. Home Health Care Company and Its Owner.The Government and the whistleblower said that the kickbacks worked, and the doctors began referring more patients to A Plus after their spouses were hired, swelling A Plus’ Medicare reimbursements from $1.1 million in 2005 to $6.6 million in 2011.
  • An Evansville, Indiana home health care agency paid the United States $1.97 million in the wake of claims that it violated the False Claims Act by treating patients without getting a physician’s approval in advance. In October 2009, the Department of Justice announced the settlement with Omni Home Care and parent company Omni Home Health. Omni disclosed the fraud to the Office of Inspector General, Department of Health and Human Services. The company acknowledged that it was supposed to have gotten physician signatures before home health care commenced, and then was required to get re-certification every 60 days thereafter. Omni admitted that it had not gotten physician signatures for some services provided to patients in Evansville, according to the Department of Justice press release
  • In February 2014, Diagnostic Imaging Group (“DIG”) paid $15.5 million to settle a case brought by three physician whistleblowers. According to the whistleblowers and the Government, DIG paid kickbacks to physicians to convince them to refer their diagnostic imaging tests to DIG. (In addition to the kickback accusations, the whistleblowers and the Government alleged that the company had defrauded Medicare and Medicaid in several other ways.) New Jersey and New York received $1.85 million to recompense losses to their Medicaid program. The federal government got the remainder of the settlement. The governments paid the three whistleblowers $1.5 million, $1.07 million, and $109,250, respectively, according to DOJ’s press release, Diagnostic Imaging Group to Pay $15.5 Million for Allegedly Submitting False Claims to Federal and State Health Care Programs.

To find out more about being a whistleblower and about stoping healthcare kickbacks, contact The Wallace Law Firm today.