A jury has found that Tuomey Healthcare System in Sumter, S.C., violated the Stark Law by paying doctors in ways that rewarded them financially for referring patients to the hospital. The jury found that more than 20,000 Medicare claims were tainted by the illegal compensation arrangements. The hospital was accused of offering doctors lucrative part-time contracts that paid above fair market value and were not commercially reasonable. The contracts contained “non-compete” provisions requiring that the doctors perform their outpatient procedures at the hospital. The doctors who accepted the contracts were paid an annual base salary plus a “productivity bonus,” which varied based on how much the hospital earned from outpatient procedures. The trial focused on dueling experts: The hospital had an appraiser’s opinion that its compensation arrangements with the physicians were consistent with fair market value; the government’s expert disagreed. The jury agreed with the government’s expert. The hospital faces up to $357 million in potential False Claims Act liabilities. Federal law requires repayment of all of the money paid under illegal Medicare claims, and the False Claims Act allows an award of up to three times the amount of total damages, plus as much as $11,000 per claim. The government’s lawsuit was commenced by a whistleblower, Dr. Michael Drakeford, under the qui tam provisions of the False Claims Act. Dr. Drakeford filed his whistleblower lawsuit after he declined to enter into one of the agreements that the hospital was offering. The whistleblower reward in this case will be between 15% and 25% of the amount collected by the government. Even if the hospital avoids treble damages and penalties by settling the case, the whistleblower reward could be in the range of $7 million to $10 million. If you have evidence that a hospital, nursing home, or other healthcare facility has agreed to pay physicians in return for referrals, then you should consult with an experienced whistleblower attorney immediately. You may be entitled to a whistleblower reward. John Howley, Esq. is an experienced Medicare and Medicaid fraud whistleblower attorney. Call our office today at (212) 601-2728 or click here to arrange a free and confidential consultation. John Howley, Esq. The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation. I invite you to contact our law offices and welcome your calls, letters and electronic mail. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established. I practice law and offer legal services only in jurisdictions where I am properly authorized to do so. I do not seek to represent anyone in any jurisdiction where this web site does not comply with applicable laws and bar rules.
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The Federal Trade Commission (FTC) has issued a proposed order that will allow up to 10 cardiologists employed by Renown Health to avoid the “non-compete” restrictions in their employment contracts. The proposed order will settle allegations that the non-compete provisions unlawfully restrain competition in violation of the antitrust laws. Renown Health is the largest provider of acute care hospital services in northern Nevada. After it acquired two competing medical groups – Sierra Nevada Cardiology Associates (SNCA) and Reno Heart Physicians (RHP) – Renown Health became the employer of virtually all the cardiologists in the Reno area. The cardiologists’ employment contracts with their former employers included "non-compete" provisions. When those employment contracts were assigned to Renown Health as part of the acquisitions, they effectively prevented the cardiologists from joining medical practices that competed with Renown Health. The FTC issued an administrative complaint against Renown Health alleging that continued enforcement of the non-compete provisions would violate the federal antitrust laws. According to the FTC's complaint, Renown Health's acquisitions created a highly concentrated market for the provision of adult cardiology services in the Reno area. The complaint alleged that the consolidation of the competing practices into a single cardiology group would eliminate competition based on price, quality, and other terms. In addition, according to the complaint, the consolidation would increase the bargaining power that Renown Health has with insurers, and this may lead to higher prices for adult cardiology services in the Reno area. The proposed order will temporarily suspend the non-compete provisions currently in place with the cardiologists. Up to 10 cardiologists will be released from the non-compete restrictions, provided that they intend to continue to practice in the Reno area for at least one year and other conditions are met. If fewer than six cardiologists have decided to leave Renown Health after 60 days, then Renown Health must continue to suspend the non-compete provisions until at least six cardiologists have accepted offers with competing practices in the Reno area. At any time, Renown Health may ask the FTC to end the release order if 10 of its cardiologists have left for competing practices. Non-compete and non-solicitation agreements are generally enforceable unless they are unreasonable in scope or duration, or they unreasonably restrain competition in violation of the antitrust laws. If you are facing a dispute over a non-compete or non-solicitation clause, you should consult with an experienced lawyer immediately to protect your rights. To schedule a free and confidential consultation by telephone or in person, call my office today at (917) 652-6504 or click here to communicate with me via email. John Howley New York, New York The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation. I invite you to contact our law offices and welcome your calls, letters and electronic mail. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established. I practice law and offer legal services only in jurisdictions where I am properly authorized to do so. I do not seek to represent anyone in any jurisdiction where this web site does not comply with applicable laws and bar rules. FBI’s Refusal to Record Witness Interviews Puts the Innocent at Risk Did you know that the FBI refuses to record most witness interviews, relying instead on “summaries” drafted by FBI agents? This creates a terrible risk for innocent people who may find themselves facing felony charges based on an inaccurate or incomplete “summary” of what they supposedly said. Here’s how it works. An FBI agent contacts you and wants to ask you a few questions. You have done nothing wrong, and you don’t want to appear uncooperative, so you agree to talk with him. His questions are fairly straightforward. There is no suggestion that you have done anything wrong. You pay no attention to his colleague who is taking notes. After the interview, the FBI agent who took notes will dictate or type up a “summary” of what you said on a Form FD-302. This will become the “official record” of what you said. A summary is, by definition, an incomplete record. In the process of taking down notes and later drafting a summary from those notes, some details will necessarily be left out. Words and phrases may be taken out of context. Intonation and emphasis will be lost. Precise words may be replaced with paraphrases. The agent will pick and choose those parts of your interview that he thinks are most important. Those choices will be guided by his subjective judgments and biases. If the agent thinks you provided evidence that helps support their case against someone else, human nature tells us that his summary will tend to emphasize the parts of your interview supporting that perspective. Fast forward to many months later. The agent who interviewed you calls again. There is still no suggestion that you have done anything wrong. He just needs you to testify against someone else before a grand jury or at trial. You have no choice. If you do not agree to testify, the U.S. Attorney will subpoena you. The agent and his colleague start to go over your “statement” as recorded on the Form 302. You are surprised. Either the agent who was taking notes did not hear you correctly, or left out important details, or the words that you actually said were taken out of context. When you start clarifying what you actually said or meant, the agents become hostile. They want to know if you were lying when you were interviewed or if you are lying now. Because if you lied during your interview, you may be charged with violating the False Statements Act, 18 USC § 1001, for making a false or fraudulent statement to a federal official. And if you contradict “your” Form 302 “statement” when you testify before a grand jury or in court, you may be charged with perjury. Either way, you could be facing up to five years in prison if you dare to contradict what the agent wrote on the Form 302. All this could be avoided, of course, if the FBI would simply record witness interviews. Then, in the event of a dispute, the judge or jury could listen to the recording and hear for themselves what you actually said. But as of this writing, the FBI’s official policy is to use audio recorders for the purpose of recording witness statements only on a limited, highly selective basis, and only when authorized by the Special Agent in Charge (SAC). What should you do if the FBI or another government investigator calls? Always consult with a lawyer before you say anything. Your lawyer can talk with the investigator or prosecutor in ways that you cannot. Most of all, your lawyer can assess the situation and advise you whether to agree to the interview or to testify only in a more formal proceeding where your statements will be recorded verbatim by a court reporter. Here’s the bottom line: If you are asked to meet with government investigators, served with a subpoena, or facing criminal charges, then you should consult with an experienced attorney immediately. We invite you to contact our office at (917) 652-6504 to discuss your options. Or click here to contact us via email. Initial consultations are free. John Howley, Esq. New York, New York The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation. I invite you to contact our law offices and welcome your calls, letters and electronic mail. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established. I practice law and offer legal services only in jurisdictions where I am properly authorized to do so. I do not seek to represent anyone in any jurisdiction where this web site does not comply with applicable laws and bar rules. |
John Howley, Esq.
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