A whistleblower has helped the federal government resolve a kickback case for $18 million after uncovering a kickback scheme defrauding Medicare and Medicaid.  According to the Department of Justice press release, a medical device company paid doctors and hospitals improper kickbacks to induce purchases of their products.

The Anti‑Kickback Statute (AKS) prohibits paying anything of value to induce the referral of items or services covered by government healthcare programs, including Medicare, Medicaid, and TRICARE.  42 U.S.C. § 1320a-7b(b).  Kickbacks can include direct payments or anything else of value.  In this case, the government cited a wide array of kickbacks, including advertising assistance, practice development, practice support, and educational grants.

Compliance with AKS and other federal laws is an express condition of payment under Medicare and Medicaid programs.  Providers who falsely certify compliance with these rules may be held civilly liable to whistleblowers and the government under the False Claims Act (FCA).

The FCA allows individuals who uncover fraud against the government to become whistleblowers and assist in recovering lost public funds.  Whistleblowers under the FCA are entitled to a share of any recovery and are protected from retaliation.  The whistleblower in this case will receive $2.65 million.  Many states also have false claims acts to defend state funds.

If you have uncovered fraud against the government, contact the whistleblower attorneys at Miller Law Group for a free and confidential consultation.  You can also set up your 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:

Filing a Whistleblower Lawsuits in Secret – The Seal Period

Telemedicine Fraud: Safely Distanced or a Smoke Screen?

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