The Anti-Kickback Statute
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The federal Anti-Kickback Statute makes it illegal to pay or receive anything of value in return for referring patients covered by Medicare, Medicaid, or another government health care program.
Hospitals, pharmacists, physicians and other healthcare providers who participate in Medicare and Medicaid must certify that they have complied with the Anti-Kickback law when seeking reimbursement. A false certification renders the claim itself false under the federal False Claims Act. A conviction can result in up to five years in prison, a fine up to $25,000, and mandatory exclusion from federal healthcare programs. The government may also recover three times the amount it paid plus $11,000 per claim. To arrange a free and confidential consultation, call John Howley, Esq. at (212) 601-2728. Examples of Illegal KickbacksBone Growth Stimulator Kickbacks
Orthofix, Inc. agreed to settle alleged violations of the False Claims Act and the Anti-Kickback statute by paying the government more than $42 million. The whistleblower who brought the qui tam lawsuit received a $9 million reward. Click here to read more.... Diagnostic Testing Kickbacks An cardiologist in Edison, NJ, admitted that he referred patients for diagnostic testing in exchange for cash kickbacks as part of a cash-for-patients scheme with a diagnostic facility. The cardiologist is the 10th person to plead guilty in connection with kickbacks involving this particular MRI and CT scan facility. Click here to read more.... Diagnostic Testing Kickbacks A physician was sentenced to five months in prison and five months of home confinement for accepting cash kickback payments from an MRI diagnostic facility in exchange for his referral of Medicare and Medicaid patients. Click here to read more.... Doctor Kickbacks A hospital will pay $12.6 million to settle claims that it made improper payments to physicians in the form of “consulting” and “advisory board” compensation in return for referrals to the hospital’s cardiology program. Click here to read more.... Doctor Kickbacks A physician was sentenced to five years in prison for billing Medicare for unnecessary neurological tests. Patients were recruited with cash payments, fast food and prescriptions for controlled substances. Click here to read more.... Durable Medical Equipment Kickbacks A physician and the owner of a medical supply company pleaded guilty to a conspiracy to defraud Medicare by submitting false claims for power wheelchairs. The physician was paid $300 for each prescription he wrote for power wheelchairs. In most instances the patient did not require or want a wheelchair, and in many instances no power wheelchair was provided. Click here to read more.... Durable Medical Equipment Kickbacks A Los Angeles-area doctor has pleaded guilty to accepting kickbacks from the makers of power wheelchairs and other durable medical equipment (DME). He faces up to 10 years in prison and a $250,000 fine. Click here to read more.... Durable Medical Equipment Kickbacks A durable medical equipment (DME) supplier was sentenced to 30 months in prison for paying kickbacks to co-conspirators for medical prescriptions and other documents he needed to defraud Medicare. He also admitted that he supplied power wheelchairs to Medicare beneficiaries who were illegally solicited by patient recruiters or “marketers” for medical equipment they did not want or need. Click here to read more.... HIV Infusion Therapy Kickbacks An employee of an HIV infusion therapy clinic was sentenced to 70 months in prison (5.8 years) for participating in his employer's scheme to pay kickbacks to Medicare beneficiaries in return for using their identities to bill Medicare for HIV infusion services that were not medically necessary and often not provided. Click here to read more.... HIV Infusion Therapy Kickbacks Two owners and operators of clinics that claimed to specialize in treating HIV and other conditions pleaded guilty to one count of conspiracy to commit health care fraud. The defendants admitted to paying physicians to refer Medicare beneficiaries to the clinics, and to purchasing Medicare beneficiary identifications for the purpose of submitting fraudulent claims to Medicare for expensive infusion therapy services that were not provided. Click here to read more.... Home Health Care Kickbacks Two patient recruiters for a home health care company pleaded guilty to soliciting kickbacks and bribes from their employer in return for recruiting patients. Their employer then billed Medicare for services that were not medically necessary and, in some cases, not provided to the patients. They each face up to five years in prison and a $250,000 fine or twice the gain or loss involved. Click here to read more.... Home Health Care Kickbacks Seven individuals were indicted and arrested on charges of using their home health care agencies to defraud Medicare of $22 million in false claims. The defendants are accused of paying kickbacks to Medicare beneficiaries in exchange for their Medicare information and signatures on documents that detailed physical therapy and/or skilled nursing services that were either never rendered or not medically necessary. Click here to read more.... Home Health Care Kickbacks The owners and operators of two home health agencies pleaded guilty to paying kickbacks to patient recruiters who supplied them with patients, prescriptions, plans of care, and certifications for therapy and home health services. The owners used these documents to submit false claims to Medicare. Click here to read more.... Home Health Care Kickbacks Three patients and a patient recruiter were convicted by a jury after trial of conspiracy to pay and receive health care kickbacks related to home health services. Click here to read more.... Hospital Kickbacks Seven hospital administrators were charged with paying kickbacks – in the form of cigarettes, food and coupons redeemable for items available at the hospital’s “country stores” – to Medicare beneficiaries in exchange for those beneficiaries’ attendance at the hospital’s partial hospitalization programs (PHP). Click here to read more.... Hospital Kickbacks New York Downtown hospital agreed to pay $13.4 million to resolve claims that it defrauded Medicare and Medicaid by, among other things, paying a hospital management company for patient referrals. Click here to read more.... MRI Kickbacks A physician was sentenced to six months in prison and six months of home detention for accepting cash kickback payments from an MRI facility, in exchange for referrals of Medicare and Medicaid patients. Twelve other physicians have also been arrested and charged with accepting similar cash kickback payments from the diagnostic testing facility. Click here to read more.... Partial Hospitalization Program (PHP) Kickbacks The owners of assisted living facilities and an affiliated psychologist received stiff prison sentences ranging from 28 months to 63 months for defrauding Medicare. The defendants paid kickbacks to other assisted living facilities for referrals of Medicare patients for Partial Hospitalization Program (PHP) treatment that was unnecessary and, in many instances, not provided. Click here to read more.... Partial Hospitalization Program (PHP) Kickbacks The owner and operator of a Florida corporation that operated several halfway houses, was sentenced to 51 months in prison after pleading guilty to receiving kickbacks in exchange for referring Medicare beneficiaries to a corporation that operated Partial Hospitalization Program (PHP) treatment programs. Click here to read more.... Patient Kickbacks The office manager of a medical clinic and the owner of an ambullette service were charged with conspiring to pay cash kickbacks to Medicare and Medicaid beneficiaries who used their medical and ambullette services. Click here to read more.... Pharmaceutical Kickbacks Victory Pharma, Inc. agreed to pay $11.4 million to settle allegations that it paid kickbacks to doctors to induce them to write prescriptions for Victory’s products. The kickbacks included tickets to sporting events, concerts and plays; spa, golf and ski outings; dinners at expensive restaurants; and numerous other out-of-office events. A former sales representative who brought the action under the False Claims Act will receive a $1.7 million whistleblower reward. Click here to read more.... Pharmaceutical Kickbacks Boehringer Ingelheim Pharmaceuticals Inc. agreed to pay $95 million to resolve allegations that it improperly promoted several of its drugs, including by paying kickbacks to health care professionals to induce them to prescribe Aggrenox, Atrovent, Combivent and Micardis. Click here to read more.... Pharmaceutical Kickbacks Former pharmaceutical sales representative Mark Giddarie will receive an $18.5 million reward for helping the government pursue a False Claims Act lawsuit against Sanofi US. Sanofi agreed to pay $109 million to settle allegations that it gave doctors kickbacks in the form of free products. Click here to read more.... Pharmaceutical Kickbacks Amgen Inc. agreed to pay $612 million to settle allegations that it illegally promoted a misbranded drug, including by offering kickbacks to influence health care providers to select its products for use. Click here to read more.... Pharmacy Kickbacks A pharmacist was sentenced to 17 years in prison for health care fraud. The pharmacist, who ownede and operated 26 pharmacies, was accused of billing Medicare and Medicaid more than $57 million drugs that were not medically necessary or not actually dispensed. He was also accused of paying kickbacks to physicians in exchange for writing prescriptions for expensive medications without regard to medical necessity. Click here to read more…. Physical Therapy Kickbacks A physician and six others were charged with conspiring to defraud the Medicare and Medicaid programs of more than $13 million by, among other things, paying and receiving health care kickbacks. The indictments allege that the defendants paid Medicare and Medicaid beneficiaries cash kickbacks to induce them to come to their clinic and receive unnecessary medical services or to stay silent when services not provided were billed to Medicare and Medicaid. Click here to read more.... Physical Therapy Kickbacks Nine defendants were charged with paying cash kickbacks to Medicare beneficiaries in exchange for physical therapy that was not medically necessary and on some occasions never provided to beneficiaries. Click here to read more.... |
John Howley, Esq.
The Howley Law Firm P.C. 350 Fifth Avenue, 59th Floor New York, New York 10118 (212) 601-2728 
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