Whistleblower

Often, there are hidden financial arrangements between various health care providers. In these arrangements, providers will provide material benefit in return for other providers prescribing or using their products or services. In many instances, these arrangements are illegal. Kickbacks result in medically unnecessary treatment. A False Claims Act lawsuit may be brought where a kickback arrangement results in the government paying for medically unnecessary services.

Examples

A company agreed to pay $161 million to settle criminal and civil liabilities for paying kickbacks to physicians for referrals for its home infusion business and growth drug, for making improper billings and for failing to keep accurate records at some of its pharmacies.

A health care provider of inpatient/outpatient services was sued under the False Claims act for violating the Medicare anti-kickback statute. The provider made guarantees and office-rent subsidies to physicians, granted low-interest or no-interest loans, forgave repayment of loans, provided staff support for a physician's private practice and entered "directorship" contracts in which physicians performed little or no services, to induce them to make referrals to the company. Settlement $2 Million

A pharmaceutical company research program that offered physicians kickbacks in grants for performing small-scale studies of its antibiotic. Investigation showed the research by the physicians was not of scientific value. In addition, many physicians did not complete the research but received full payment The company agreed to pay $450,000 to settle the Medicare Fraud claim.

A pharmaceutical company research program that offered physicians kickbacks in grants for performing small-scale studies of its antibiotic. Investigation showed the research by the physicians was not of scientific value. In addition, many physicians did not complete the research but received full payment The company agreed to pay $450,000 to settle the Medicare Fraud claim.