An Oklahoma whistleblower who helped uncover an illegal kickback scheme has helped the state and federal governments recover over $72.3 million.

According to the Department of Justice press release, a hospital, management group, and a physicians group engaged in a scheme to provide improper remuneration in exchange for patient referrals.  The kickbacks were paid by providing (1) discounted office space; (2) excessive compensation; (3) equity buybacks; and (4) preferential investment opportunities.

Under the Anti-Kickback Statute, it is illegal to offer, pay, or receive kickbacks for referrals of Medicare patients.  42 U.S.C. § 1320a-7b(b).  It applies to various forms of government healthcare, including Medicare, Medicaid, and Tricare.  As in the present case, kickbacks can include a wide array of remuneration beyond simple cash exchanged for referrals.

Similarly, under the Stark Law, it is a violation for physicians to refer patients to a facility if they have a financial relationship with that facility.  42 U.S.C. § 1395nn (a)(1), (h)(6).

The False Claims Act (FCA) allows individuals who have uncovered fraud against government to bring a civil action and recover lost public funds.  The whistleblower—known under the act as a relator—is entitled to share in any recovery.  In the present case, the whistleblower stands to receive approximately 25% of the total recovery.

If you have uncovered fraud against the government, contact the whistleblower lawyers at Miller Law Group today for a free and confidential consultation.  You can also set up a consultation by calling us at (919) 348-4361.

The settlement discussed above is based on allegations only.  No determination of liability has been made.

Additional Resources

STARK: When can physicians refer patients to their group practice?

Telemedicine Fraud: Safely Distanced or a Smoke Screen?

Recent Developments in Whistleblower Protection