Stark Law: Legal Cases
The Stark Law makes it illegal for a hospital, home health agency, dialysis
center, etc., to pay a doctor to refer patients to them. Do you know of
a situation where doctors are getting paid to steer their patients to
a particular nursing home, home health agency or hospital? Is a physicians’
practice getting a sweetheart deal on its rent, or getting free billing services?
Medicare and Medicaid depend on whistleblowers like you to file suit under the False Claims Act and the Stark Law. If you have
information about a healthcare provider that is giving doctors cash, hiring
their spouses for cushy, low-work jobs, or making them cut-rate deals
for rent or billing, you can stop fraud and also
get a percentage of what the government recovers.
Find out how during a
FREE case consult: (888) 581-9132.
Whistleblowers Are Making a Difference in Stark Act Cases
Wondering what a Stark Act case looks like? Here are some cases where whistleblowers
made a difference, stopping medical providers who were bribing doctors
and helping the Government get money back.
Some examples of legal cases involving the Stark Act include:
Below Market Rates for Patient Coordination Services: Seven whistleblowers split $26 million after they brought accusations
that home health services giant Amedisys had violated the Anti-Kickback
Statute and the Stark Statute. Amedisys paid the Government $150 million
to resolve these claims as well as accusations that the company was charging
for unnecessary services or unnecessary levels of service to its home
In cases filed in Pennsylvania and Georgia, the whistleblowers said that
Amedisys, which has offices in 37 states, was giving cut-rate “patient
care coordination services” to a Georgia oncology practice. Instead
of charging full price for the services, the relators said that the home
health company was charging artificially low (below-market) rates. Under
the provisions of the False Claims Act, the whistleblowers (also known
as relators) collectively received a percentage of what the Government
collected. Amedisys is based in Baton Rouge, Louisiana.
Accepting Referrals from a Doctor Who Was Also the Medical Director: Thanks to a lawsuit brought by a coder at a nationwide chain of acute
care services, Community Health Systems Inc. (CHS) paid the Government
$9,000,000 to settle Stark Act claims.
The company paid the Government a total of $98.15 million to resolve the
suit, which included allegations that the company had billed Medicare
and Medicaid for expensive inpatient services, when it knew that the services
should have been charged at the lower outpatient or observation services
rate. As part of the package settlement, CHS paid $9,000,000 to settle
claims that one of its acute care hospitals, LMC of Laredo, Texas, had
violated the Stark Law by accepting referrals from a physician who was
offered a medical directorship at LMC.
press release, DOJ said: “The Stark Law prohibits a hospital from submitting claims
for patient referrals made by a physician with whom the hospital has an
improper financial relationship, and is intended to ensure that a physician’s
medical judgment is not compromised by improper financial incentives,
and is instead based on the best interests of the patient.”
Bonuses for Ordering Lucrative Tests and Prescription Drugs: A whistleblower received $20.8 million for bringing a False Claims Act
suit against Halifax Hospital Medical Center and Halifax Staffing Inc.
According to the
DOJ press release,
Florida Hospital System Agrees to Pay the Government $85 Million to Settle
Allegations of Improper Financial Relationships with Referring Physicians , the whistleblower accused the two Daytona Beach healthcare providers
of paying improper bonuses to six medical oncologists. The hospital calculated
the bonuses in part by evaluating how much lucrative business the doctors
were sending the hospital’s way. When the doctors prescribed drugs
and tests for Halifax’s patients, Halifax charged Medicare for the
drugs and tests, and then chipped the doctors in for a piece of the action.
The more tests and drugs that a doctor prescribed, the more money the
hospital made and the more the physician made. The problem with bonus
systems like this one, said Stuart Delery, the Assistant Attorney General
for DOJ’s Civil Division, is that they “encourage physicians
to make decisions based on financial gain rather than patient needs.”
Contact an Atlanta Stark Law Attorney Today – (888) 581-9132
Do you know of a hospital, nursing home or healthcare provider that is
violating the Stark Act? To find out more about lawsuits involving Stark
Law violations, contact The Wallace Law Firm today. A past president of
the Georgia Association for Women Lawyers and the Georgia Bar's Product
Liability Section, Lee puts her 25 years of experience to work for whistleblowers.
Contact our Atlanta Stark Law lawyer today for a free consultation.