Healthcare Compliance Perspective:
The Anti-Kickback Statute makes it a crime for healthcare providers to pay or receive any remuneration to induce referrals for services reimbursable by a federal health care program. Remunerations can include but are not limited to, marketing services, advertising, cash, vacation stipends, or below market value rent. Violating the Anti-Kickback Statute may result in false claims, Corporate Integrity Agreements, Civil Monetary Penalties, imprisonment, or exclusion.
A physician-owned hospital serving the Dallas/Fort Worth area, has agreed to pay $7.5 million to resolve claims that it violated the False Claims Act by paying physicians kickbacks in the form of marketing services in exchange for surgical referrals.
The government alleged that, between 2009 and 2014, the hospital engaged in an illegal kickback scheme to pay for marketing and/or advertising services for some physicians. These paid advertisements included local and regional publications, radio and television, internet pay-per-click campaigns, billboards, website upgrades, brochures, business cards and other marketing venues. In return, the physicians would refer their surgical patients, including Medicare and TRICARE beneficiaries, to the hospital.
As part of the settlement, the hospital has agreed to enter into a corporate integrity agreement with the Department of Health and Human Services Office of Inspector General (HHS-OIG), which obligates the defendants to undertake substantial internal compliance reforms for the next five years.
The settlement resolves allegations originally brought in a lawsuit filed by whistleblowers under the qui tam provisions of the False Claims Act, which allow private parties to bring suit on behalf of the government and to share in any recovery. The whistleblowers, two former employees of the hospital’s marketing department, will receive $1,125,000.