The U.S. Department of Justice recently announced a $3.8 million settlement with Catholic Medical Center (CMC) to resolve allegations that it violated the False Claims Act by providing free call coverage to a cardiologist in exchange for patient referrals. Government attorneys said these actions violated the Anti-Kickback Statute.
The federal government alleged CMC paid its cardiologists to be available to provide medical services on behalf of a cardiologist while she was on vacation or unavailable for work. In addition, settlement documents revealed allegations that CMC provided these services at no charge to the cardiologist.
In return, the cardiologist referred patients for medical procedures and services to CMC. Over the decade in which this arrangement took place, the cardiologist sent millions of dollars in work to CMC. The United States claimed this constituted a violation of the Anti-Kickback Statute because CMC submitted claims for payment for these referred services to Medicare, Medicaid and other healthcare programs.
Every year the federal government suffers billions of dollars in losses due to healthcare fraud, including through illegal kickback schemes like this. In many cases, the only reason these schemes are uncovered is due to the assistance of whistleblowers who report their knowledge of wrongdoing within their organizations.
The information you have as an employee of a healthcare organization can be incredibly valuable in preventing significant waste of taxpayer money. For more information about the steps you can take if you become aware of healthcare fraud within you workplace, contact an experienced whistleblower attorney at Kardell Law Group.