Stark Law: Legal Cases
The Stark Law makes it illegal for a hospital, home health agency, dialysis center, etc., to pay a doctor to refer patients to them. Do you know of a situation where doctors are getting paid to steer their patients to a particular nursing home, home health agency or hospital? Is a physicians’ practice getting a sweetheart deal on its rent, or getting free billing services?
Medicare and Medicaid depend on whistleblowers like you to file suit under the False Claims Act and the Stark Law. If you have information about a healthcare provider that is giving doctors cash, hiring their spouses for cushy, low-work jobs, or making them cut-rate deals for rent or billing, you can stop fraud and also get a percentage of what the government recovers.
Find out how during a FREE case consult: (404) 550-4615.
Whistleblowers Are Making a Difference in Stark Act Cases
Wondering what a Stark Act case looks like? Here are some cases where whistleblowers made a difference, stopping medical providers who were bribing doctors and helping the Government get money back.
Some examples of legal cases involving the Stark Act include:
- Below Market Rates for Patient Coordination Services: Seven whistleblowers split $26 million after they brought accusations that home health services giant Amedisys had violated the Anti-Kickback Statute and the Stark Statute. Amedisys paid the Government $150 million to resolve these claims as well as accusations that the company was charging for unnecessary services or unnecessary levels of service to its home health patients.In cases filed in Pennsylvania and Georgia, the whistleblowers said that Amedisys, which has offices in 37 states, was giving cut-rate “patient care coordination services” to a Georgia oncology practice. Instead of charging full price for the services, the relators said that the home health company was charging artificially low (below-market) rates. Under the provisions of the False Claims Act, the whistleblowers (also known as relators) collectively received a percentage of what the Government collected. Amedisys is based in Baton Rouge, Louisiana.
- Accepting Referrals from a Doctor Who Was Also the Medical Director: Thanks to a lawsuit brought by a coder at a nationwide chain of acute care services, Community Health Systems Inc. (CHS) paid the Government $9,000,000 to settle Stark Act claims.The company paid the Government a total of $98.15 million to resolve the suit, which included allegations that the company had billed Medicare and Medicaid for expensive inpatient services, when it knew that the services should have been charged at the lower outpatient or observation services rate. As part of the package settlement, CHS paid $9,000,000 to settle claims that one of its acute care hospitals, LMC of Laredo, Texas, had violated the Stark Law by accepting referrals from a physician who was offered a medical directorship at LMC.In its press release, DOJ said: “The Stark Law prohibits a hospital from submitting claims for patient referrals made by a physician with whom the hospital has an improper financial relationship, and is intended to ensure that a physician’s medical judgment is not compromised by improper financial incentives, and is instead based on the best interests of the patient.”
- Bonuses for Ordering Lucrative Tests and Prescription Drugs: A whistleblower received $20.8 million for bringing a False Claims Act suit against Halifax Hospital Medical Center and Halifax Staffing Inc. According to the DOJ press release, Florida Hospital System Agrees to Pay the Government $85 Million to Settle Allegations of Improper Financial Relationships with Referring Physicians , the whistleblower accused the two Daytona Beach healthcare providers of paying improper bonuses to six medical oncologists. The hospital calculated the bonuses in part by evaluating how much lucrative business the doctors were sending the hospital’s way. When the doctors prescribed drugs and tests for Halifax’s patients, Halifax charged Medicare for the drugs and tests, and then chipped the doctors in for a piece of the action. The more tests and drugs that a doctor prescribed, the more money the hospital made and the more the physician made. The problem with bonus systems like this one, said Stuart Delery, the Assistant Attorney General for DOJ’s Civil Division, is that they “encourage physicians to make decisions based on financial gain rather than patient needs.”
Contact an Atlanta Stark Law Attorney Today – (404) 550-4615
Do you know of a hospital, nursing home or healthcare provider that is violating the Stark Act? To find out more about lawsuits involving Stark Law violations, contact The Wallace Law Firm today. A past president of the Georgia Association for Women Lawyers and the Georgia Bar’s Product Liability Section, Lee puts her 25 years of experience to work for whistleblowers.
Contact our Atlanta Stark Law lawyer today for a free consultation.