Government Targets Physicians Who Accept Kickbacks

OIG Announces Increased Scrutiny of Compensation for Medical Directorships for Possible Violations of the Anti-Kickback Statute.  

The government sent a stern warning to physicians that their compensation for medical directorships will be scrutinized for compliance with the Anti-Kickback Statute.

In a recent press release, the Office of Inspector General (OIG) at the Department of Health and Human Services announced that it will be paying careful attention to two aspects of medical directorship compensation. 

First, the compensation must reflect the fair market value of bona fide services that the physician actually provides. 

Second, the amount of compensation must not be based, in whole or in part, on the volume or value of patients referred by the physician.

Many physician compensation arrangements are legitimate.  A compensation arrangement may violate the Anti-Kickback Statute, however, if any part of it is based on the physician's past or future referrals of patients who receive Medicare, Medicaid, or other government healthcare benefits.

The compensation arrangements subject to increased scrutiny are not limited to cash payments.  Physicians may violate the Anti-Kickback Statute if they accept free services, subsidized office staff, below-market rent for office space, or anything of value in return for patient referrals.

Once a kickback has been paid, every resulting claim for reimbursement submitted to Medicare or Medicaid is considered a "false claim" under the False Claims Act, even if the services were medical necessary and actually provided.  Individuals responsible for submitting false claims may be required to pay back three times the amount the government paid for the services, plus a penalty of up to $11,000 per claim.

If you have evidence that a physician is accepting kickbacks in return for patient referrals to a hospital, diagnostic imaging center, medical lab, or other healthcare provider, then you should consult with an experienced whistleblower lawyer immediately.  You may be eligible for a reward of up to 30% of the amount the government recovers.

To schedule a free and confidential consultation with an experienced whistleblower lawyer, call John Howley, Esq. at (212) 601-2728.