Kickbacks are hidden financial arrangements between a person and an organization. Usually, these type of cases involve fraud in the healthcare system and can come in several forms. However, one basic principle is in every kickback case – the healthcare provider will provide some sort of benefit in return for other providers to prescribing or using that provider’s services or products.
Kickbacks are usually considered illegal. The doctor or healthcare provider should be using their own opinions on a patient’s treatment and not be swayed by financial gain. Federal laws, such as the Anti-Kickback Statute and the Stark Statute, prohibits kickbacks because it can lead to unnecessary treatment or the use of expensive products. Because of these actions, higher costs are given to patients, their insurances, Medicare, and Medicaid.
Federal Laws Prohibiting Kickbacks
The Anti-Kickback Statute – According to this law, a company is considered to have committed fraud when it offers healthcare providers, such as doctors or hospitals, financial incentives to use that company’s products or services. The payment is made under Medicare, Medicaid, or other federally funded healthcare programs. The kickback doesn’t necessarily have to be money exchanging hands; it can come in items of monetary value such as a free vacation. Hospitals and other companies may try to disguise the kickback as payment for serviced rendered. However, as long as the payment is used to influence a healthcare provider, it is considered a kickback.
The Stark Statute – This law regulates the financial relationship between a physician and a company that sells healthcare items or services. If a healthcare provider benefits from referring patients to a particular hospital or testing center, patients can suffer by being treated to unnecessary and sometimes dangerous treatments.
Sanford Heisler Sharp Kickback Cases
At Sanford Heisler Sharp, LLP, our whistleblower attorneys have represented many clients in kickback cases. Some of our cases include:
- A $116 million non-intervened settlement of claims against a long-term care pharmacy arising from unlawful kickbacks paid to nursing homes to induce drug purchases.
- A $5.1 million non-intervened settlement arising from unlawful kickbacks paid by ambulatory surgical center owners to physicians to induce referrals of patients to ASCs.
If you are aware of a hidden financial arrangement between a person and an organization and would like to speak with a whistleblower attorney about your potential kickback case, contact Sanford Heisler Sharp today.