Doctors’ Self-Referrals Triggered the False Claims Act, Judge Says

October 13, 2014

A federal judge held that physicians violated the False Claims Act when they made referrals to a hospital that used a radiation imaging company in which the doctors had financial interests.

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Cardiology Group Will Pay $1.3 Million to Settle Claims of Improper Referrals

September 23, 2014

The U.S. Department of Justice (DOJ) said it obtained a $1.3 million settlement of allegations that a cardiology practice violated the False Claims Act and the Stark Act by knowingly compensating its physicians based on the number of tests that the physicians referred.

The Stark Act prohibits a physician from referring Medicare patients for designated health services to an entity with which the physician has a financial relationship (unless an exception applies). The Stark Act does not permit a practice to compensate a physician based directly on the volume or value of the physician’s referrals for services not personally performed by the ordering physician.

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Whistleblower Nurse Reaps $15 Million Reward in Amedisys Fraud Settlement

May 09, 2014

The U.S. Department of Justice announced settlements with several healthcare companies accused of fraud — including a massive $150 million deal with Amedisys Inc. in which the government resolved seven lawsuits with the giant homecare provider, leading to more than $26 million in payouts to whistleblowers and a jackpot for U.S. taxpayers.

The largest whistleblower reward, more than $15 million, went to April Brown, an Alabama nurse and single mother who was fired by Amedisys after she questioned its Medicare billing practices.

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After Blowing Whistle on Itself, Utah Hospital Chain Agrees to Pay $25.5 Million

May 07, 2013

Utah’s Intermountain Healthcare Inc. will pay $25.5 million to settle claims that it violated federal laws, including the Stark Law against profit-driven referrals by doctors.

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