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Kickback and Physician Self-Referral

In each CMP case resolved through a settlement agreement, the settling party has contested the OIG's allegations and denied any liability. No CMP judgment or finding of liability has been made against the settling party.

2014

10-24-2014 OIG Enforcement Case
New Jersey Doctor Enters Settlement Agreement with OIG on Kickback Allegations
Dr. Rajan Shah - a Newark, NJ gastroenterologist - entered into a settlement agreement with the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services, effective October 24, 2014. The $104,950.00 settlement resolves allegations that Dr. Shah received remuneration from Orange Community MRI, LLC, an imaging facility in Orange, NJ, in exchange for patient referrals. Senior Counsel David M. Blank and Lauren E. Marziani represented OIG in this case.
10-03-2014
After they self-disclosed conduct to OIG, DLP Maria Parham Medical Center, LLC (DLP Maria Parham) and Henderson/Vance Healthcare, Inc. (HVH), North Carolina, agreed to pay $141,459.59 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. OIG alleged that DLP Maria Parham and HVH paid remuneration to a physician in the form of free useable office space not identified in or accounted for in their existing written lease agreement or in any written amendment to the lease agreement.
08-21-2014 Notificaion: Press Announcement
Florida-based Distributor Enters Settlement Agreement with OIG on Kickback Allegations
Zimmer-Deptula, Inc. (ZDI) - a former Florida-based distributor for Zimmer, Inc. - entered into a $123,000 settlement agreement with the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services, effective August 21, 2014. This settlement resolves allegations that ZDI violated the Civil Monetary Penalties Law by paying kickbacks. Specifically, OIG alleges that two ZDI independent contractors paid third parties to recommend Zimmer, Inc. products to Florida-based physicians. OIG contends that ZDI knowingly and willfully offered and paid the kickbacks to the third parties to induce them to recommend and arrange for the purchase of Zimmer, Inc. products which were paid for by Federal health care programs. Senior Counsel David M. Blank, Robert M. Penezic, and Lauren E. Marziani represented OIG in this case.
05-21-2014 Notificaion: Press Announcement
New Jersey Doctor Enters Settlement Agreement with OIG on Kickback Allegations
Ansar Sharif, M.D. - former owner of a Kearny, NJ, medical practice - entered into a settlement agreement with the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services, effective May 20, 2014. The $52,280 settlement resolves allegations that Sharif received kickbacks from Orange Community MRI, LLC, a diagnostic testing facility, in exchange for patient referrals.

To date, the United States Attorney's Office for the District of New Jersey convicted 17 defendants - including 15 physicians - in connection with the government's ongoing investigation of illegal payments made by Orange MRI. The investigation by OIG's Office of Investigations indicated that Sharif received money from Orange MRI for patient referrals. This case marks the first Civil Monetary Penalty Law resolution stemming from the government's investigation of Orange MRI. OIG was represented by Senior Counsel David M. Blank and Lauren E. Marziani. Sharif was represented by Carmine Campanile.
04-25-2014
Harper's Hospice Care, Inc. (Harper's Hospice), Mississippi, agreed to pay $150,000 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. OIG alleged that Harper's Hospice paid remuneration to a physician in the form of medical directorship fees. Specifically, the OIG contends that Harper's Hospice paid the remuneration to the physician in exchange for the physician referring patients to Harper's Hospice for hospice services and pre-singing blank prescription forms for patients treated by Harper's Hospice.
03-24-2014
After it self-disclosed conduct to OIG, Ukiah Valley Medical Center (UVMC), California, agreed to pay $1,692,588 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks. OIG alleged that UVMC paid improper remuneration to physicians who invested in a joint venture ambulatory surgical center with UVMC.

2013

12-23-2013
After it self-disclosed conduct to OIG, Havasu Regional Medical Center (Havasu), Arizona, agreed to pay $510,179.44 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. OIG alleged that Havasu paid remuneration to a doctor in the form of the allowed rental of usable space at a below-market rental rate and the inappropriate provision of employee services.
12-13-2013
A physician assistant (PA) agreed to be excluded from participating in Federal health care programs for a period of five years under 42 U.S.C. § 1320a-7(b)(7). OIG alleged that the PA knowingly and willfully received illegal remuneration in exchange for referring patients for the furnishing of items or services for which payment may be made in whole or in part under a Federal health care program. OIG further alleged that the PA referred patients to health care entities for physical therapy and home health care services in exchange for illegal kickbacks in violation of the Anti-Kickback Statute.
12-03-2013
After it self-disclosed conduct to OIG, Kishwaukee Community Hospital (Kishwaukee), Illinois, agreed to pay $230,320 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. OIG alleged that Kishwaukee paid remuneration to three medical group practices in the forms of a cash collections guarantee, start-up expenses, and loan forgiveness to subsidize the practices recruitment of a midwife, an advanced practice nurse practitioner, and a certified nurse practitioner.
11-15-2013
After it self-disclosed conduct to OIG, Helen Newberry Joy Hospital (HNJH), Michigan, agreed to pay $221,080.47 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. OIG alleged that HNJH entered into improper financial relationships with a doctor involving the lease of space, discounted internet service, professional liability and health insurance, arrangement for office supplies and pharmaceuticals, arrangement for back-up call coverage, physician supervision and attendance at certain medical leadership meetings, and failure to collect interest on an outstanding loan balance.
10-21-2013
In connection with the resolution of False Claims Act liability, two owners of a durable medical equipment company agreed to be excluded from participating in Federal health care programs for a period of twenty years under 42 U.S.C. § 1320a-7(b)(7). OIG alleged that the owners, through their company, entered into contracts with marketing companies whereby, in violation of the Anti-Kickback Statute, the company paid for referrals from marketing companies when Medicare beneficiaries ordered diabetic supplies.
10-17-2013
Henry Schein, Inc. (Henry Schein), New York, agreed to pay $1,140,260 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that Henry Schein offered and paid remuneration to customers that are members of its Henry Schein Medical Privileges Program in the form of points redeemable for products and services, which do not qualify as "discounts" or "rebates" under the anti-kickback statute.
10-02-2013
After it self-disclosed conduct to the OIG, United General Hospital - Public Hospital District 304 (UGH), Washington, agreed to pay $74,067 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that UGH paid remuneration to a physician in the form of excessive compensation for services performed at its facility.
09-26-2013
After it self-disclosed conduct to the OIG, St. Vincent's East (St. Vincent's), Alabama, agreed to pay $50,000 for allegedly violating the Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that St. Vincent's paid remuneration to a sports medicine practice in the form of payment for Durable Medical Equipment (DME). Specifically, the OIG alleged that St. Vincent's arranged to purchase DME prescribed by the sports medicine practice physician for their patients' inpatient stay directly from the sports medicine practice.
09-27-2013
After it self-disclosed conduct to the OIG, Mercy Medical Center, Inc. (Mercy), Maryland, agreed to pay $50,000 for allegedly violating the Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that Mercy paid remuneration to a physician owned real estate company in the form of not collecting net profits from the real estate company due under an agreement between Mercy and the real estate company. Further, this agreement established Mercy's right to forty percent of the net profits the real estate company and Mercy obtained as joint owners of a property.
09-13-2013
After it self-disclosed conduct to the OIG, Molina Healthcare of Florida, Inc. (Molina), Florida, agreed to pay $257,111 for allegedly violating the Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that Molina offered to increase the capitation rates paid to four physicians in exchange for the referral of their patients to Molina and did increase the capitation rates of two of the four physicians.
06-13-2013
A former pharmaceutical sales representative and sales manager for Sanofi, agreed to be excluded from participating in Federal health care programs for five years under 42 U.S.C. § 1320a-7(b)(7). OIG alleged that the sales representative provided samples of the viscosupplement Hyalgan to physicians with the expectation that the physicians would bill Medicare for the samples. OIG further alleged that the sales representative provided an agreed number of samples with each order of a specified size, that these off-the-books discounts constituted remuneration under the Anti-Kickback statute (42 U.S.C. § 1320a-7b(b)(2)), and that these alleged kickbacks were provided for the purpose of assuring the physicians' continued use of the product.
04-03-2013
Paul Lux, M.D., Missouri, agreed to pay $63,900 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that Dr. Lux received remuneration from a medical device manufacturer in the form of payments made under a clinical registry contract.
03-05-2013
After it self-disclosed conduct to the OIG, Hospital Authority of Benn Hill County, Georgia d/b/a Dorminy Medical Center (Dorminy), Georgia, agreed to pay $50,000 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that Dorminy paid remuneration to a doctor in the form of free use of hospital space for a period of time.
02-25-2013
Edward Desser (Desser), a Florida resident, agreed to pay OIG $120,000 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks. OIG alleged that Desser owned and operated International Orthopedic Solutions (IOS), an orthopedic medical device distributorship that sold Ortho Development Corporation products, and ECM Solutions, LLC (ECM), a medical consulting/business development company. OIG alleged that Desser, by and through ECM, received remuneration from for the purpose of recommending the ordering of Zimmer, Inc. (Zimmer), orthopedic products by a Florida-based physician. OIG also alleged that Desser paid remuneration to two individuals to induce them to recommend the purchasing of medical devices by Florida orthopedic surgeons. OIG contends that Desser knowingly and willfully solicited and received the remuneration described above to induce a person(s) to order Zimmer orthopedic products for which payment was made by Federal health care programs. OIG also contends that Desser knowingly and willfully offered and paid remuneration to two individuals to induce them to recommend the ordering of orthopedic products for which payment may have been made by Federal health care programs.

2012

11-14-2012
In connection with the resolution of False Claims Act liability, a diagnostic testing facility agreed to be excluded from participating in Federal health care programs for a period of ten years under 42 U.S.C. § 1320a-7(b)(7). OIG alleged that the diagnostic testing facility: (1) paid remuneration to physicians in connection with the referral of Medicare patients to the diagnostic testing facility for diagnostics tests; (2) submitted provider enrollment documents that were false or contained material omissions; and (3) submitted or caused to be submitted claims for payment for diagnostic tests requiring that a qualified physician be present in the office suite in order for the tests to be payable by Medicare that either were not supervised, or were supervised by physicians who did not have the requisite qualifications to supervise the tests and/or had not been approved by Medicare.
11-02-2012
ForTec Medical, Inc., ForTec Litho, LLC, ForTec Litho Florida, LLC, ForTec Litho Central, LLC, and ForTec Litho NY, LLC (collectively, ForTec), Illinois, agreed to pay $126,249.30 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that ForTec provided customers (including physicians) an all-expense paid trip to the Masters Golf Tournament. The OIG concluded that the trips were intended to induce referrals.
09-25-2012
After it self-disclosed conduct to the OIG, Carlsbad Medical Center, LLC (CMC), New Mexico, agreed to pay $995,380 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that CMC paid remuneration to three orthopedists in the form of improper payments for on-call coverage, malpractice insurance, travel reimbursement, and overpayments under an income guarantee agreement.
09-11-2012
After it self-disclosed conduct to the OIG, Sleep Services of America, Inc. and Do You Snore of Maryland, LLC (SSA and DYSM), Pennsylvania, agreed to pay $1,006,104.29 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that the problematic arrangements included leases with doctors, medical directorships, personal services contracts and loans to referral sources.
After it self-disclosed conduct to the OIG, New England Sinai Hospital, Inc. (NESH), Massachusetts, agreed to pay $1,149,396.50 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that NESH paid remuneration to two physicians in the form of: 1) free, or less than fair market value, space and staff; 2) payment for services not performed and services performed pursuant to expired agreements; and 3) paid remuneration to a physicians group in the form of payment for services not performed and services performed without a written agreement.
07-23-2012
In connection with the resolution of False Claims Act liability, the owner of a diagnostic testing facility agreed to be excluded from participating in Federal health care programs for a period of four years under 42 U.S.C. § 1320a-7(b)(7). OIG alleged that the diagnostic testing facility owner: (1) paid remuneration to physicians in connection with the referral of Medicare patients for diagnostic tests; (2) submitted provider enrollment documents that were false or contained material omissions; and (3) submitted or caused to be submitted claims for payment for diagnostic tests requiring that a qualified physician be present in the office suite in order for the tests to be payable by Medicare that either were not supervised, or were supervised by physicians who did not have the requisite qualifications to supervise the tests and/or had not been approved by Medicare.
07-16-2012
In connection with the resolution of False Claims Act liability, a radiologist and a diagnostic testing facility agreed to be excluded from participating in Federal health care programs for a period of six years under 42 U.S.C. § 1320a-7(b)(7). OIG alleged that the radiologist, through the diagnostic testing facility, entered into prohibited financial relationships with physicians. Specifically, OIG alleged that these prohibited financial relationships included: (1) sham personal services contracts (Medical Directorships) that took into account the value of referrals from the Medical Directors; and (2) contracts to pay the salaries of employees in physicians' offices that took into account the value of referrals from those physicians.
07-05-2012
After it self-disclosed conduct to the OIG, LipoScience, Inc., North Carolina, agreed to pay $151,785 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that LipoScience paid remuneration to employees and referring doctor's offices in the form of thousands of gift cards.
06-22-2012
After it self-disclosed conduct to the OIG, Good Samaritan Hospital Medical Center (Good Samaritan) and South Bay OB/GYN (South Bay), New York, agreed to pay $1,753,447.40 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that Good Samaritan paid remuneration to South Bay physicians that were more than fair market value because they did not account for the value of the benefits of malpractice insurance premium payments made for the physicians.
After it self-disclosed to the OIG, Good Samaritan Hospital Medical Center (Good Samaritan), New York, agreed to pay $604,780.73 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that Good Samaritan paid remuneration to a physician in the form of salary and benefits under a contract for leadership, teaching, and administrative services. The salary and benefits paid were above fair market value.
06-21-2012
In connection with the resolution of False Claims Act liability, a physical rehabilitation and pain management clinic (clinic) agreed to be excluded from participating in Federal health care programs for twenty years under 42 U.S.C. § 1320a-7(b)(7). OIG alleged that the clinic: (1) submitted claims to Medicare and Medicaid for physical therapy, electrodiagnostic testing, and/or home health care services that were referred to companies that were owned or operated by the clinic's owner in exchange for illegal remuneration and/or kickbacks and (2) submitted claims to Medicare and Medicaid using medical billing codes that reflected more complex and expensive services than the services that were actually rendered to patients.
01-20-2012
After it self-disclosed conduct to the OIG, Advanced Physical Therapy, PLLC and Richard Brannin, PT (collectively respondents), West Virginia, agreed to pay $62,460 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that the respondents accepted patients for treatment who presented with a physician's written order for physical therapy from Richard Brannin's spouse. The respondents indirectly paid remuneration to Richard Brannin's spouse. As a result, the respondents presented claims to Medicare for physical therapy services that were furnished pursuant to prohibited referrals.

2011

11-29-2011
After it self-disclosed conduct to the OIG, City Hospital, Inc., The Charles Town General Hospital d/b/a Jefferson Memorial Hospital, and West Virginia University Hospitals-East, Inc. (collectively respondents), West Virginia, agreed to pay $949,595 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that the respondents entered into several arrangements with physicians or physician groups for which the hospitals failed to collect office rental payments. The conduct included: (1) payments of costs and expenses pursuant to recruitment agreements in excess of the actual additional incremental costs; (2) payment of student loans without a written recruitment agreement; and (3) payment of costs and expenses pursuant to unwritten extensions of recruitment agreements.
10-04-2011
After it self-disclosed conduct to the OIG, County of Monterey d/b/a Natividad Medical Center (NMC), California, agreed to pay $174,508.46 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that NMC entered into a professional medical services agreement with a physician group for certain call coverage and clinic services. The compensation terms of the agreement offered incentives for the physician group to refer their private practice and medically indigent adult patients to NMC.
10-03-2011
After it self-disclosed conduct to the OIG, Westfields Hospital, Wisconsin, agreed to pay $204,150 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that Westfields Hospital provided space, services, and supplies to certain physician group practices without entering into a formal written contract and without collecting payment.
9-08-2011
After it self-disclosed conduct to the OIG, Whidbey Island Hospital District (WIHD), Washington, agreed to pay $858,571 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that WIHD had over 100 violations surrounding various physician contracts and arrangements. Some of the violations included: (1) a number of hospitalist contracts had expired and new contracts had not been signed; (2) there were no written agreements in place for a number of medical staff leadership and call coverage arrangements; and (3) a variety of improper lease arrangements, personal service arrangements, malpractice subsidies, and a housing allowance and an equipment loan with one physician.
07-13-2011
After it self-disclosed conduct to the OIG, Good Samaritan Hospital Medical Center (GSHMC), New York, agreed to pay $55,018.50 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that GSHMC entered into an improper financial relationship with a physician professional corporation. The contract did not specify the terms of the intended agreement and the physician profession corporation received accelerated payments from GSHMC that did not comply with contractually agreed to payments. The payments were not consistent with fair market value.
07-13-2011
After it self-disclosed conduct to the OIG, St. Catherine of Siena Medical Center (St. Catherine), New York, agreed to pay $2,596,014 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that St. Catherine contracted with a physician owned professional services company. The company received remuneration that was not consistent with fair market value and received payments for services that were not performed under the contract.
05-11-2011
After it self-disclosed conduct to the OIG, Pacifica Hospital of the Valley (Pacifica), California, agreed to pay $764,250 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that Pacifica paid indirect improper remuneration to a physician in the form of payments to a marketing firm for marketing services that were never rendered under joint marketing agreements. The remuneration created a financial relationship between Pacifica and the physician that caused Pacifica to present claims for health services that resulted from prohibited referrals in violation of the Stark law.
03-24-2011
After it self-disclosed conduct to the OIG, Fairview Northland Regional Health Care (FNRHC), Minnesota, agreed to pay $50,000 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that FNRHC entered into an unwritten lease agreement with a physician practice.

2010

12-03-2010
After it self-disclosed conduct to the OIG, Wayne County Hospital (WCH), Kentucky, agreed to pay $110,000 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that WCH: 1) paid remuneration to a physician by failing to charge processing fees for payroll services rendered to his practice; 2) paid remuneration to a physician and failed to demand or collect payroll processing fees and payments due for personnel and practice management support services rendered to her practice; and 3) paid remuneration to two physicians by failing to demand repayment of wages and benefits paid to the physicians and their staff and failed to charge processing fees for payroll services rendered to the practice.
11-09-2010
After it self-disclosed conduct to the OIG that it discovered had occurred at another hospital with which it had merged, St. Elizabeth Medical Center, Kentucky, agreed to pay $1,216,511 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that St. Elizabeth entered into an improper billing arrangement for "provider-based services" involving a rural outreach program that had occurred at another hospital prior to its acquisition by St. Elizabeth. In addition, the OIG alleged that the acquired hospital entered into several improper financial relationships with a referring physician that violated the Stark Law and the Anti-Kickback Statute.
10-21-2010
Steven J. Lancaster, M.D., Florida, agreed to pay $101,000 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks. The OIG alleged that Dr. Lancaster solicited kickbacks from a medical device manufacture. Dr. Lancaster sought to leverage his product usage and ability to influence purchasing decisions in exchange for a consulting agreement with a guaranteed payment. In addition, he sought to obtain a personal service agreement.
09-03-2010
After it self-disclosed conduct to the OIG, South Coast Medical Center (SCMC), California, agreed to pay $72,637.77 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that SCMC entered into multiple lease and personal services arrangements with doctors that raised compliance issues under the Stark Law and Anti-Kickback Statute.
07-21-2010
After it self-disclosed conduct to the OIG, Mercy Medical Center, Inc. (MMC), Maryland, agreed to pay $195,013.50 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that MMC entered into physician service arrangements, lease arrangements, physician on-call arrangements and billing and collection agreements that raised potential issues under the Stark Law and the Anti-Kickback Statute.
07-08-2010
United Shockwave Services, United Urology Centers, and United Prostate Centers (collectively, United), Illinois, agreed to pay $7,359,500 and entered into a five year CIA for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that United and certain physician-investors used their ability to control patient referrals to obtain contract business from various hospitals. Specifically, United threatened hospitals that it would refer patients to competing hospitals if the respective hospital did not agree to a contract with United, or promised hospitals that did contract with United additional referrals. The relationships between United's physician-investors and the hospitals raised Stark concerns regarding the financial relationships between United's physician-investors and the hospitals to which they made referrals. Also, United sold more shares to physicians who produced more referrals or other business for the company. United had processes for having physicians divest if they did not use United's services sufficiently and offered huge returns on investment with virtually no business risk.
06-17-2010
After it self-disclosed conduct to the OIG, St. John's Regional Medical Center (SJRMC), Missouri, agreed to pay $274,815 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that SJRMC entered into an improper financial relationship with a physician. SJRMC allowed the physician to be regularly delinquent in rent under a written lease agreement and paid the physician for services without a written contract in place.
06-07-2010
After it self-disclosed conduct to the OIG, Christus Spohn Hospital Corpus Christi- Memorial (Memorial), Texas, agreed to pay $4,130,536 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that: (1) Memorial paid indirect remuneration to family medicine and emergency medicine faculty physicians in the form of (a) salary and benefit reimbursements to the faculty physicians' employer that were more than fair market value for the time the physicians spent fulfilling their contractual duties to Memorial and (b) billing and collections services associated with the faculty physicians' practices to an educational foundation and successor entity; (2) Memorial paid remuneration to certain family medicine faculty physicians in the form of charging rent below fair market value for office space on the fifth and sixth floors of Memorial's hospital; and (3) Memorial paid remuneration to two entities providing services proscribed by the Ethical and Religious Directives for Catholic Health Care Services in the form of the entities' staffing, equipment, and billing for the facility fees associated with the proscribed services and paying those fees to the involved entities.
06-03-2010
Cochlear Americas, Colorado, agreed to pay $880,000 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks. The OIG alleged that Cochlear Americas paid various forms of illegal remuneration to physicians who prescribed the use of their manufactured implant system for Medicare and Medicaid patients.
05-11-2010
After it self-disclosed conduct to the OIG, Surgical Specialty Center of Baton Rouge, LLC (provider), Louisiana, agreed to pay $51,300 for allegedly violating the Civil Monetary Penalties Law provisions applicable to the Stark Law. The OIG alleged that the provider entered into several types of financial arrangements with referring physicians without the requisite written agreements in place as required by the Stark Law.
05-03-2010
After it self-disclosed conduct to the OIG, Colorado West HealthCare System d/b/a Community Hospital and its subsidiary, Doctor's Clinic Building, Inc. (Colorado West), Colorado, agreed to pay $420,175 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks and physician self-referrals. The OIG alleged that Colorado West entered into six categories of contractual arrangements (i.e., medical director arrangements, emergency room services, office leases, on-call physician arrangements, continuing medical education services, and diagnostic test interpretations) that violated the Stark Law and, in some instances, implicated the Anti-Kickback Statute in connection with physicians' referrals of Medicare beneficiaries to Colorado West.
04-20-2010
After it self-disclosed conduct to the OIG, St. Elizabeth Hospital and Mercy Medical Center of Oshkosh, Inc. (hospitals), Wisconsin, both part of the Affinity Health System, agreed to pay $54,124 for allegedly violating the Civil Monetary Penalties Law provisions applicable to the Stark Law. The OIG alleged that the hospitals disclosed payments to three independent psychiatrists who provided behavioral health services at the hospitals' emergency rooms. Specifically, the on-call coverage arrangements between the psychiatrists and hospitals failed to comply with Stark Law requirements.
03-31-2010
After it self-disclosed conduct to the OIG, St. James Healthcare (SJH), Montana, agreed to pay $275,000 for allegedly violating the Civil Monetary Penalties Law provisions applicable to the Stark Law. The OIG alleged that SJH entered into a space lease, an employee lease, and a medical services arrangement with an entity partly owned by SJH that failed to meet Stark Law requirements because they were not set forth in writing and signed.
03-01-2010
After it self-disclosed conduct to the OIG, Liberty HealthCare Systems, Inc. (Liberty), New Jersey, agreed to pay $225,000 to resolve its liability for allegedly violating the Civil Monetary Penalties Law provisions applicable to the Stark Law. The OIG alleged that Liberty made an improper bonus payment to an employee physician based, in part, on the volume and value of referrals made by the physician.
02-16-2010
Harvey Montijo, M.D., Florida, agreed to pay $650,000 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks. The OIG alleged that Dr. Montijo solicited and received remuneration in the form of consulting payments from two medical device manufactures in exchange for using their orthopedic hip and knee products.
02-08-2010
Garden State Imaging (GSI), New Jersey, agreed to pay $83,000 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks. The OIG alleged that GSI entered into a verbal agreement with two owners of a medical center. Under the terms of the verbal agreement, GSI agreed to provide mobile diagnostic imaging and related services to the medical center's patients and to split with the medical center 50% of the net proceeds that were generated.
01-22-2010
After it self-disclosed conduct to the OIG, St. Mary Medical Center - Long Beach (St. Mary), California, agreed to pay $494,374 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks. The OIG alleged that St. Mary paid remuneration to a medical group and its owner in the form of administrative services from a St. Mary's employee and paid remuneration through leased space and a medical director agreement.
01-06-2010
After it self-disclosed conduct to the OIG, Inland Imaging, LLC (Inland), Washington, agreed to pay $155,000 for allegedly violating the Civil Monetary Penalties Law provisions applicable to the Stark Law. The OIG alleged that Inland provided certain outpatient radiology services to Medicare beneficiaries based on orders written by physicians who were immediate family members of three individuals who held indirect ownership interests in Inland.

2009

12-10-2009
After it self-disclosed conduct to the OIG, Piedmont Hospital, Inc., Georgia, agreed to pay $126,322 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks and physician self-referrals. The OIG alleged that Piedmont's financial relationships with 22 physicians failed to meet Stark law and Anti-Kickback statute requirements. The majority of the arrangements involved payment for services performed without a fully-executed written contract, one arrangement involved a physician who was paid at rates differing from the contract rate, and other arrangements involved payment for services that were not set forth in a contract.
12-02-2009
After it self-disclosed conduct to the OIG, Oswego Hospital, New York, agreed to pay $2,134,037 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks and physician self-referrals. The OIG alleged that Oswego's financial relationships with more than 20 physicians failed to meet Stark law requirements. Most of the violations involved the hospital's failure to comply with Stark law requirements for recruitment arrangements, office leases, professional service arrangements, and the provision of discounted employee benefit plan premiums to non-employed physicians.
11-04-2009
After it self-disclosed conduct to the OIG, Allied Health Care Corporation (Allied), Florida, agreed to pay $132,500 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks and physician self-referrals. The OIG alleged that two physicians that were shareholders in Allied made referrals to two home health agencies which were wholly owned subsidiaries of Allied.
10-20-2009
Robert Diaz, M.D. (Diaz), Florida, agreed to pay $65,000 and to be excluded from participating in Federal health care programs for three years for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks. The OIG alleged that Diaz solicited and received remuneration in the form of consulting payments from a medical device manufacturer in exchange for using their orthopedic hip and knee products.
10-16-2009
After it self-disclosed conduct to the OIG, Medina General Hospital (MGH), Ohio, agreed to pay $240,298 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks and physician self-referrals. The OIG alleged that MGH's financial relationships with a family practice physician, occupational health services physicians, and a cardiologist failed to meet Stark Law requirements. Specifically, the financial relationships were during periods when there were no written service agreements or payments were not made consistent with the contracts.
After it self-disclosed conduct to the OIG, Vascular Specialty Services, Inc. (VSSI), Maryland, agreed to pay $34,182 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks and physician self-referrals. The OIG alleged that VSSI's financial relationship with four vascular surgeons failed to meet Stark law requirements. Specifically, VSSI added lab referral revenues into a bonus pool that was paid to the vascular surgeons.
09-25-2009
Michael Bakst, the former Executive Director of Community Memorial Hospital (CMH) of Ventura, California, agreed to pay $64,000 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks. The OIG alleged that Bakst caused the submission of claims to Medicare in violation of the physician self-referral (Stark) law. During the relevant time period Bakst was also identified as CMH's Compliance Officer.
09-17-2009
After it self-disclosed conduct to the OIG, Liberty HealthCare System, Inc. (Liberty), New Jersey, agreed to pay $417,675 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks. The OIG alleged that one of Liberty's hospitals failed to reflect an increase in compensation and hours of service in a written pediatric coverage agreement with a physician practice that provided pediatric coverage services to MHMC.
08-11-2009
After it self-disclosed conduct to the OIG, Cushing Memorial Hospital (CMH), Kansas, agreed to pay $50,000 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks and physician self-referrals. The OIG alleged that CMH's financial relationship with a cardiologist failed to meet Stark Law requirements. Specifically, the cardiologist was engaged to provide medical director services to CMH's cardiac rehabilitation unit. However, the written agreement was not signed. In addition, CMH's office space lease with the cardiologist did not meet the applicable lease exception.
08-03-2009
After it self-disclosed conduct to the OIG, Central Kansas Medical Center (CKMC), Kansas, agreed to pay $50,000 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks and physician self-referrals. The OIG alleged that CKMC entered into two lease arrangements, with a referring-physician-owned partnership, that failed to comply fully with the Stark law's requirements for such financial arrangements.
07-31-2009
After self-disclosing to the OIG, Kahuku Hospital, Hawaii, agreed to pay $75,000 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks and physician self-referrals. The OIG alleged that Kahuku Hospital entered into services agreements with emergency room physicians where payments were made in excess of the amount provided for in the agreement and entered into other arrangements with emergency room physicians that were not in writing.
07-10-2009
After it self-disclosed conduct to the OIG, Inova Health Care Services d/b/a Inova Fairfax Hospital (Inova), Virginia, agreed to pay $528,158 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks and physician self-referrals. The OIG alleged that Inova paid remuneration to Arrhythmia Associates (AA) in the form of services provided by certain physician assistants (PA) within the office of AA. Specifically, Inova provided PA services to AA without written contracts in place and failed to bill and collect for those PA services.
06-26-2009
After it self-disclosed conduct to the OIG, Memorial Hospital of Union County (MHUC), Ohio, agreed to pay $31,202 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks and physician self-referrals. The OIG alleged that MHUC provided excess non-monetary compensation to physicians and the immediate family member of a physician who referred patients to MHUC.
02-09-2009
After it self-disclosed conduct to the OIG, Jewish Hospital and St. Mary's Healthcare (JHSMH), Kentucky, agreed to pay $130,000 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks and physician self-referrals. The OIG alleged that JHSMH entered into an arrangement with a physician for a Medical Director position that included the physician being paid compensation in excess of his Medical Director agreement and receiving free nurse services for his private practice without any contractual entitlement to such services.
01-27-2009
After it self-disclosed conduct to the OIG, San Jacinto Methodist Hospital (SJMH), Texas, agreed to pay $21,025.62 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks and physician self-referrals. The OIG alleged that SJMH entered into an arrangement with a physician for a Medical Director position that included the physician occupying hospital space for private use and utilizing hospital personnel for clerical assistance related to the physician's private practice patient visits without any contractual entitlement to do so.

2008

12-03-2008
After it self-disclosed conduct to the OIG, The King's Daughters' Hospital and Health Services (Hospital), Indiana, agreed to pay $391,500 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks. The OIG alleged that the Hospital had compensation arrangements with employed physicians that failed to comply fully with the Stark Law's restrictions on productivity bonuses. Specifically the physicians were compensated for services that were not personally performed by them.
11-26-2008
After self-disclosing conduct to the OIG, Bioscrip, Inc. and Bioscrip Pharmacy, Inc. (Bioscrip), agreed to pay $795,000 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks and prohibited physician self-referrals. The OIG alleged that Bioscrip stationed a pharmacist, from its West Hollywood, California pharmacy, at two physician practices and that, while on-site at the physician practices, the pharmacist provided services for the pharmacy with the practices as well as services that benefitted the physician practices (without a lease), including services that otherwise would have been provided to patients by the physician practices. Patients of the physician practices, including those counseled by the on-site Bioscrip pharmacist, were referred to and filled prescriptions paid for by the Medicare Part D program at a Bioscrip pharmacy.
11-04-2008
Abbott Northwestern Hospital, Minnesota, agreed to pay $350,000 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals. The OIG alleged that Abbott made physician salary guarantee payments to three Sports and Orthopedic Specialists without entering into written physician recruitment agreements with the recruited physicians.
10-01-2008
Valerie Tolley d/b/a Health Care Medical (HCM), Mississippi, agreed to pay $100,000 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks. The OIG alleged that HCM made payments and attempted to make payments of kickbacks in exchange for direct and indirect patient referrals.
08-11-2008
After it self-disclosed conduct to the OIG, Ivinson Hospital, Wyoming, agreed to pay $635,000 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks. The OIG alleged that Ivinson paid prohibited remuneration to physicians in the form of free rent, equipment and furnishings, leases at less-than-fair-market value, reimbursement for medical-director services in excess of fair-market value, and reimbursement in excess of the requirements of an income-guarantee agreement.
08-04-2008
Bernhardt Laboratories, Inc. (BLI), Michael J. Bernhardt, M.D., and Michael J. Bernhardt, M.D.P.A., Florida, agreed to pay $100,000 for allegedly violating the Civil Monetary Penalties Law b y submitting claims in violation of the Stark Law. The OIG alleged that Michael Bernhardt, M.D. referred patients to BLI for clinical laboratory services. The referrals to BLI violated the Stark Law in that BLI was owned by Michael Bernhardt's brother.
05-10-2008
After it self-disclosed conduct to the OIG, Spartanburg Regional Healthcare System, South Carolina, agreed to pay $780,000 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks. The OIG alleged that Spartanburg provided information technology (IT) resources to non-employee physician groups without written contracts in place. Specifically, Spartanburg reported that it failed to document IT agreements with ten different physician practices/groups and also failed to bill and collect for those IT resources.
03-27-2008
MedCare Home Health and its owner Wilfred Braceras, Florida, agreed to pay $178,000 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks. The OIG alleged that Medcare and Braceras paid kickbacks to a "coordinator" to induce the referral of home health care patients. The recipient of the kickbacks was not an employee, had no contract, and was paid based on the volume and value of the referrals. Braceras's home health care chain, B& B Holdings Enterprises, Inc. d/b/a South Eastern Health Management Association, Inc., also entered into an addendum to the existing corporate integrity agreement.
01-23-2008
After it self-disclosed conduct to the OIG, University Health Services, Inc. d/b/a University Hospital (collectively UHS), Georgia, agreed to pay $137,429 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks and physician self-referrals. The OIG alleged that UHS hired an athletic trainer to participate in a community service program to provide sports medicine coverage to area high school and middle school sports teams. If a student was injured, the trainer occasionally provided follow-up care for free at the offices of a local orthopedic practice. While in the practice's offices, the trainer would occasionally provide services to patients for the benefit of the practice. The agreement between UHS and the practice was never formalized in writing and the practice did not pay UHS for the services provided by the trainer for its benefit.

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