Doctor Gets $4.6M for Blowing Whistle on Over-Compensated Doctors

Neurologist Dr. David Hammett will receive $4,590,000 as part of a settlement entered into by Lexington Medical Center (LMC) of West Columbia, S.C., and the federal government.  Ironically, the hefty compensation comes as a result of Dr. Hammett’s blowing the whistle on LMC for over-compensating some of its …

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Same Per-Click Rule, New Rationale

On July 7 CMS issued a proposed rule reaffirming its position that the Stark Law prohibits “per-click” rent payments when the lessor is the one referring the patients to the lessee for the “click,” e.g., the test or procedure.  Say, for example, a physician leases an X-ray machine to an imaging center. …

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Aetna Wins $37.5 Million for Overbilling Scheme

It’s easy to fall into the habit of regarding self-referrals and kickbacks as strictly a matter of federal law, governed only by the federal Stark Law and Anti-Kickback Statute.  But an April 13 verdict in California provides a vivid reminder that state law also has a role and that private insurers can be as …

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U.S. Sides with Defendant Against Whistleblower—Sort of

Today’s riddle: why would the government take the defendant’s side against the whistleblower in a False Claims Act qui tam case?  Why would the government challenge the whistleblower’s claim that two defendants violated the Stark Law, insisting instead that they met a Stark exception? A Georgia federal …

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Health Care Fraud and Abuse Enforcement Priorities in Minnesota

United States Attorney for the District of Minnesota, Andrew Luger, spoke at a public event on March 3, 2016, at Mitchell-Hamline School of Law on the topic of health care fraud & abuse enforcement priorities in Minnesota. Luger began the discussion explaining the resource shortage issue in the white collar …

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Suing the Hand that Feeds You

Jeffrey Jacobs alleges that Idaho’s Pocatello Hospital violated the False Claims Act because of physician recruitment contracts that were overly generous to his practice group.  Jeff should know because he was recruited under one of the contracts and worked for the group for three years. According to the …

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