2 Laboratories Pay $48.5 Million to Settle Anti-Kickback Claims

According to a recent Department of Justice press release, two cardiovascular testing laboratories – Health Diagnostic Laboratories (“HDL”) and Singulex – recently entered into a settlement agreement for a combined $48.5 million.   The settlements resolve a qui tam complaint which alleged that HDL and Singulex violated state and federal anti-kickback statutes and false claims acts and submitted claims to government and private insurers for “medically unnecessary” services. The settlement was the result of a whistleblower lawsuit which alleged that the… Read More >

Improper Management Agreements Serve as Basis for $10 Million Dollar Settlement

The Department of Justice (DOJ) released a statement on March 31, 2015 discussing a recent settlement agreement with Robinson Health System, Inc., based in Ohio. The settlement arose from allegations that the health system had violated both the Anti-Kickback Statute and the Stark self-referral prohibition by entering into management agreements with physician groups who allegedly did not provide sufficient bona fide management services to justify the amount of the payments. This settlement is a good reminder to physician groups and… Read More >

OIG Says Waiver of Laboratory Fees Could Violate Anti-Kickback Statute

In OIG Advisory Opinion 15-04, the requestor, a multi-regional medical laboratory proposed to enter into agreements with physician practices which would allow the requestor to provide all laboratory services for the physician’s patients. The requestor indicated that physicians desired such a relationship because it would provide for better communication and consistency (e.g. consistent reference ranges and interfaces). The current barrier to such a relationship is the requirement by certain “Exclusive Plans” that labwork be sent only to certain designated laboratories… Read More >

Physician Certification of Home Health Patients For Remuneration Found to be “Referral” and Violation of Anti-Kickback Statute

On February 10, 2015, in the case of United States v. Patel, the Seventh Circuit Court of Appeals affirmed the judgment of the District Court which found Dr. Kamal Patel, an internal medicine specialist, guilty of violating the Anti-Kickback Statute.  The case resulted from a federal investigation which revealed that Dr. Patel had received payments from Grand Home Health Care (“Grand”) for certifying and recertifying home care patients’ plans of care. Dr. Patel’s argument on appeal was that the certification… Read More >