March 21, 2014 — Every U.S. taxpayer bears the cost of Medicare fraud. The government relies on health care insiders to take notice of False Claims Act violations and to help stop them. The qui tam provisions in the statute give tipsters a way to do what’s right. Informants willing to collaborate with the government by filing a lawsuit on its behalf may be entitled to a portion of the government’s eventual recovery.
False Claims Act Settlement Resolves Allegations of Stark Act Violations by Kentucky Physicians Whose Drug Addiction Clinic Referred Expensive Drug Testing to Clinical Lab Owned by Same Physicians
Health care providers offering addiction recovery services to Kentucky Medicare and Medicaid beneficiaries have settled False Claims Act allegations for $15.75 million. The providers include: SelfRefind, an addiction treatment clinic chain; PremierTox LLC, a clinical laboratory that conducts urine testing for SelfRefind; and Drs. Robin Peavler and Bryan Wood, who own SelfRefind and PremierTox. The agreement resolves allegations that the providers submitted false claims to government healthcare programs for testing that was not needed, not as costly as the bills submitted indicated or filed with the government in violation of the Stark Law.
After Peavler and Wood acquired an ownership stake in PremierTox in 2010, SelfRefind’s clinics started to refer comprehensive urine drug screening analyses to PremierTox. The expensive tests were medically unnecessary and cost much more than available alternative tests, according to the Justice Department. The practice also was alleged to violate the Stark Law, which prevents a laboratory from billing government healthcare programs for services referred to the lab by doctors who have an ownership interest in the laboratory.
Inside Employees Work to Expose Medicare Fraud
Health care employees frequently identify Medicare fraud and Stark Act violations right from the start. But most have no idea how to file a whistleblower lawsuit. To protect their own interests, tipsters need to understand the False Claims Act process before they notify the government. With qui tam lawyers in multiple offices from coast to coast, Waters & Kraus is devoted to protecting tipsters’ rights. Contact us by email or call our Medicaid fraud lawyers at 855.784.0268 to discuss how we can work together to fight health care fraud.