In a major development in the fight against healthcare fraud, several medical professionals and companies have agreed to settle claims over their involvement in a laboratory kickback scheme.
The parties involved include Dr. Gerald Congdon, Dr. Gbenga Aluko, Dr. Anup Banerjee, Curis Healthcare Inc., and Saeed Medical Group Ltd.
The settlements total $1.9 million and resolve allegations that these providers received kickbacks for referring Medicare and TRICARE beneficiaries to a laboratory in South Carolina for unnecessary tests.
Details of the Settlement and Allegations
The U.S. Department of Justice announced that these healthcare providers and businesses agreed to pay substantial amounts to resolve the claims.
The accused entities allegedly violated the False Claims Act by accepting kickbacks in exchange for referring patients to the laboratory in Anderson, South Carolina.
These kickbacks were disguised as office space rental and phlebotomy payments, among other payments for services.
In return, the providers would refer patients for laboratory testing, which resulted in false claims to Medicare and TRICARE.
- Dr. Gerald Congdon and Coastal Practices: Dr. Congdon, operating in Pawleys Island and Myrtle Beach, South Carolina, and his associated practices agreed to pay $400,000 to settle allegations of receiving disguised kickbacks from 2016 to 2021.
- Dr. Gbenga Aluko and Eagle Medical Center: Dr. Aluko, based in Charlotte, North Carolina, will pay $250,000 to resolve similar charges involving kickbacks from 2016 to 2021.
- Dr. Anup Banerjee and Gastonia Medical Specialty Clinic: Dr. Banerjee, operating in Gastonia, North Carolina, settled for $206,000 over allegations spanning from 2017 to 2021.
- Omar Hussain and Curis Healthcare: Hussain, alongside his marketing company based in South Miami and Chicago, has agreed to pay $817,808. The company allegedly received commissions from the South Carolina laboratory between 2020 and 2021 in exchange for arranging referrals.
- Saeed Medical Group and Hussain: Saeed Medical Group Ltd., along with Hussain’s company, settled for $240,000, resolving allegations of kickbacks paid for referring patients to the laboratory between 2020 and 2021.
Government Response and Statements
The Department of Justice has emphasized the ongoing commitment to holding medical professionals accountable for their actions, particularly those who compromise the integrity of healthcare programs.
Principal Deputy Assistant Attorney General Brett A. Shumate remarked, “Kickbacks can undermine the integrity of taxpayer-funded healthcare programs, distort medical decisions, and result in unnecessary services.”
The U.S. Attorney for the District of South Carolina, Brook B. Andrews, highlighted the importance of maintaining integrity in healthcare, stressing that kickback schemes divert critical funds and focus away from patient care.
Special agents from the FBI, the Department of Health and Human Services Office of Inspector General (HHS-OIG), and the Defense Criminal Investigative Service (DCIS) have all worked collaboratively to pursue these allegations.
Broader Implications and Ongoing Investigations
These settlements are part of a larger initiative to address health care fraud, and the government continues to focus on detecting and dismantling fraudulent schemes within the healthcare system.
The case also illustrates how organizations and individuals can potentially prioritize financial incentives over patient welfare, compromising both medical judgment and the trust of taxpayers.
The settlements conclude the government’s investigation into certain medical providers in South Carolina, North Carolina, and Texas.
However, investigations into other participants in the alleged scheme are ongoing, and the Department of Justice has urged the public to report any concerns related to fraud, waste, or abuse in healthcare.
The Commitment to Combat Healthcare Fraud
This case serves as a strong reminder of the government’s commitment to combatting healthcare fraud through tools like the False Claims Act.
The federal government remains vigilant in investigating and prosecuting healthcare fraud to protect the integrity of the healthcare system and ensure that it serves the best interests of patients.
The claims resolved in these settlements are allegations only, and there has been no determination of liability.
However, these agreements demonstrate the serious consequences of engaging in healthcare fraud schemes.