Does compensating a physician in exchange for his referral of patients for durable medical equipment and compound pharmaceutical pain cream prescriptions violate the Anti-Kickback Law?
Compliance Perspective – Illegal Kickbacks
Policies and Procedures: The Compliance Officer will review the policies and procedures with the Administrator regarding vendor contracts and the required background investigation, including data bases for excluded individuals and companies, prior to the execution of a contract. Training: Staff involved in the contract process will review the protocols to use in completing the vendor background investigation process and become familiar with required documentation and information to be provided by the vendor prior to execution of a contract. Audit: The Compliance Officer will ensure that an audit is performed on a regular basis to determine if vendors providing services to the facility have been excluded or sanctioned regarding Medicare and Medicaid. Periodically, a review is needed to ensure that policies, procedures and training are updated, and that all employees have been trained.
A U.S. District Court Judge recently sentenced Ryan Williamson and William Pierce to one year in prison and nine months’ imprisonment, respectively. The sentences were given as a result of the pair’s guilty pleas for their involvement in a conspiracy to pay unlawful kickbacks to a local doctor for referring patients to A&G Spinal Solutions, LLC (“A&G Spinal”)—the defendants’ durable medical equipment company. Along with the sentences, the Court entered monetary judgments of $1,593,564.54 against Williamson and $803,007.25 against Pierce. Those judgments represent the proceeds the two received from the conspiracy.
The plea agreements indicate that beginning in 2010, Williamson and Pierce conspired with an interventional pain management doctor operating in Fort Myers FL to pay compensation to him in exchange for his referrals to their company (A&G Spinal). For the referrals, A&G Spinal paid a percentage of the resulting profits via checks that were made payable to the doctor’s wife. His wife was unaware of the scheme and was not associated with A&G Spinal.
Additionally, from 2013 to 2015, Williamson also paid kickbacks to the doctor in exchange for patient referrals for compound pharmaceutical pain cream prescriptions.
The doctor has pleaded guilty for his role in both schemes and is currently awaiting sentencing.
