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Vijesh Patel, M.D. and his office manager and wife Laju Patel, both of Port Neches, Texas, have agreed to pay $422,789 to resolve False Claims Act allegations that they received illegal kickbacks in violation of the Anti-Kickback Statute in return for referring patients for laboratory testing, and both have agreed to cooperate with the Department of Justice’s investigations of, and litigation against, other participants in the alleged schemes.
“Kickbacks can undermine a physician’s medical judgment, result in unnecessary testing, and increase health care costs borne by taxpayers,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “We will continue to pursue physicians, laboratories, and others responsible for schemes that violate rules intended to safeguard the integrity of federal health care programs.”
The Anti-Kickback Statute prohibits offering, paying, soliciting, or receiving remuneration to induce referrals of items or services covered by Medicare, Medicaid and other federally funded healthcare programs. The Anti-Kickback Statute is intended to ensure that medical providers’ judgments are not compromised by improper financial incentives and are instead based on the best interests of their patients.
The settlement announced today resolves allegations that Dr. and Mrs. Patel received kickbacks in violation of the Anti-Kickback Statute in return for Dr. Patel’s referrals to three laboratories:
“Patients deserve to know that the decisions their health care providers are making are based solely on their medical needs, not on some profit-making scheme,” said U.S Attorney Philip R. Sellinger for the District of New Jersey. “Our office will continue to pursue anyone responsible for actions that have the potential to corrupt the medical decision-making process.”
“This settlement demonstrates the Eastern District of Texas’s firm and continued commitment to pursuing all persons responsible for engaging in kickback schemes that inevitably harm the taxpayers, increase costs to care, and decrease access to health care,” said U.S Attorney Brit Featherston for the Eastern District of Texas. “We remain vigilant in our pursuit to put a stop to those who partake in kickback schemes of this kind and to hold them accountable for the collective harm they caused.”
“Patients should be able to trust that their doctor’s medical recommendation is in their best interest and not influenced by the doctor’s financial gain,” said U.S. Attorney Adair F. Boroughs for the District of South Carolina. “Our office has and will continue to hold accountable those that give and receive illegal kickbacks, both to maintain the public’s trust in the healthcare system and to ensure taxpayer money is properly spent.”
“Health care providers engaging in kickback schemes corrupt the provider-patient relationship and impose hidden costs on the health care system,” said Assistant Special Agent in Charge Susan A. Frisco with the Department of Health and Human Services Office of Inspector General (HHS-OIG). “Alongside our law enforcement partners, our agency is committed to safeguarding the integrity of federal health care programs by holding individuals who unlawfully bill the programs accountable for their actions.”
“Today’s outcome demonstrates the steadfast determination of the Department of Defense (DoD) Office of Inspector General’s Defense Criminal Investigative Service (DCIS) and our investigative partners to root out fraud perpetrated against TRICARE,” said Acting Special Agent in Charge Gregory P. Shilling for the DCIS Southwest Field Office. “DCIS remains focused on protecting and preserving valuable taxpayer dollars by holding those accountable who attempt to defraud the DoD.”
The settlement was the result of a coordinated effort between the Civil Division’s Commercial Litigation Branch, Fraud Section and the U.S. Attorneys’ Offices for the Eastern District of Texas, District of New Jersey, and District of South Carolina, with assistance from HHS-OIG and DCIS. To date, the United States has recovered over $32 million relating to conduct involving True Health or MSO kickbacks to physicians in Texas, including False Claims Act settlements with 34 physicians, two health care executives, one office manager, and one laboratory. In addition, the United States has filed a lawsuit under the False Claims Act against former True Health CEO Christopher Grottenthaler and others, which is captioned United States ex rel. STF, LLC v. True Health Diagnostics, LLC, et al., No. 4:16-cv-547 (E.D. Tex.). A defendant who violates the act is liable for three times the amount of the government’s losses plus applicable penalties.
The settlement announced today was handled by Senior Trial Counsel Christopher Terranova in the Civil Division’s Commercial Litigation Branch (Fraud Section), Assistant U.S. Attorney Kruti Dharia for the District of New Jersey, Assistant U.S. Attorneys James Gillingham, Adrian Garcia and Betty Young for the Eastern District of Texas, and Assistant U.S. Attorney Beth C. Warren for the District of South Carolina.
The government’s pursuit of this matter illustrates the government’s emphasis on combating healthcare fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement can be reported to the Department of Health and Human Services, at 1-800-HHS-TIPS (800-447-8477).
The claims resolved by the settlement are allegations only, and there has been no determination of liability.
Physician and Office Manager Agree to Pay Over $420000 to Settle … – Department of Justice
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