Doctor and Pharmacist Penalized in False Claims Act Case

Medical and pharmaceutical fraud takes many forms. There are many ways to provide an illegal inducement besides cash delivered in a paper bag. As kickback schemes grow more complex and difficult to detect, the importance of whistleblowers who take affirmative steps to stop fraud grows. 

One example of an illegal inducement case involves a doctor receiving excessively high rent payments. A Department of Justice press release states that Biolab, a medical laboratory, paid above-fair-market-value rent to Dr. Stephen Swetech for a room within his Clinton Township, Michigan building. This apparently was so that Dr. Swetech would refer patients to the lab, a kickback that violated the federal False Claims Act. 

Dr. Swetech faced another allegation relating to his relationship with Yasser Maisari, owner of Heartland Drugs. The government says Dr. Swetech issued medically unnecessary prescriptions for opioids and drugs to treat attention-deficit/hyperactivity disorder (ADHD). Most of these medications were provided by Heartland, and government healthcare programs, such as Medicare and Medicaid, paid for these drugs that were dispensed inappropriately. 

To settle the case against them, Swetech and Maisari paid a combined amount of approximately $700,000. It can be very difficult for outsiders to know that professionals within the medical industry are engaging in unlawful conduct. However, if you have a job in healthcare, you might be able to collect a payment if you have information about illegal inducements or other types of fraud.

Healthcare providers and affiliated businesses should be aware of potential signs of malfeasance, such as:

  • Lack of internal self-controls — Regular audits and independent monitoring of billing practices can help identify and prevent potential compliance issues. A healthcare provider that does not emphasize the importance of following the law as it relates to billing and fraud prevention might have something to hide.

  • Suspicious relationships or financial arrangements — There might be cause for suspicion when a doctor’s office seems to have unexplained financial ties to a laboratory, pharmaceutical dispenser or tenant.

  • Excessive prescriptions — Healthcare providers are required to exercise caution when prescribing controlled substances, such as opioids and ADHD medications. If prescriptions do not seem medically necessary or are not appropriately documented, it could be a sign of illegal activity. 

Employees within the healthcare industry are on the frontlines when it comes to stopping medical fraud. Don’t hesitate to speak to the attorneys at Kardell Law Group if you see something wrong. We provide strong legal support to whistleblowers and can discuss if you are eligible to receive payment for exposing impropriety.