Settlement of Alleged Kickback Violations
Physicians and medical practices in Missouri and St. Louis have agreed to pay a total of $653,796 to resolve allegations of violating the False Claims Act.
The accusations revolve around illegal kickbacks, which were purportedly received in violation of the Anti-Kickback Statute.
These kickbacks were allegedly given in exchange for referring patients for laboratory testing. Additionally, the parties have committed to cooperating with the Justice Department’s investigations into other participants in these alleged schemes.
The Impact of Kickbacks on Healthcare Providers
Principal Deputy Assistant Attorney General Brian M. Boynton, who heads the Justice Department’s Civil Division, emphasized that kickbacks can have a detrimental effect on healthcare providers’ medical decisions.
These illegal inducements are designed to influence medical choices, which can undermine the integrity of patient care.
Anti-Kickback Statute and its Purpose
The Anti-Kickback Statute prohibits the offering, paying, soliciting, or receiving of remuneration to encourage referrals of services covered by federal healthcare programs, including Medicare and Medicaid.
Its primary purpose is to ensure that medical providers base their judgments on patient well-being rather than improper financial incentives.
The settlements announced in this case address the allegations against Drs. Gregory Stynowick, Chad Shelton, and Michael Boedefeld, as well as their respective medical practices.
Dr. Stynowick and Pain Management Medical Center Settlement
Dr. Stynowick and Pain Management Medical Center have agreed to pay $257,436 to resolve two allegations. T
he first allegation pertains to the period from May 2017 to July 2018 when Pain Management Medical Center allegedly received payments from Beachwood Services LLC (Beachwood) in exchange for referrals to Landmark Diagnostics LLC and Sprint Diagnostics LLC.
The second allegation covers the period from August 2018 to January 2020 when the medical center allegedly received payments from Alari Group LLC (Alari) for referrals to Genesis Reference Laboratories LLC and InHealth Diagnostic LLC.
Dr. Shelton, Dr. Boedefeld, and Pro Pain Settlement
Dr. Shelton, Dr. Boedefeld, and Pro Pain have agreed to pay $396,360 to resolve two allegations.
The first allegation relates to the period from February 2017 to September 2018 when Pro Pain allegedly received payments from Beachwood for referrals to Landmark and Sprint.
The second allegation covers the period from July 2018 to October 2020 when Pro Pain allegedly received payments from Alari for referrals to Genesis, InHealth, and American Institute of Toxicology Inc. (AIT).
Importance of Compliance with the Anti-Kickback Statute
U.S. Attorney Philip Sellinger for the District of New Jersey highlighted the significance of adhering to the Anti-Kickback Statute, emphasizing that schemes involving kickbacks for medical tests can violate federal laws.
The U.S. Attorney’s Office is committed to using appropriate tools to safeguard the integrity of federal healthcare systems.
Collaborative Efforts and Safeguarding Healthcare Systems
Special Agent in Charge Naomi Gruchacz of the Department of Health and Human Services Office of Inspector General (HHS-OIG) stressed the importance of collaboration between individuals and entities participating in the federal healthcare system.
She highlighted that violations of the Anti-Kickback Statute can lead to medically unnecessary testing and subpar results, which can adversely affect patient care.
Coordinated Effort and Settlement Details
The settlements resulted from a coordinated effort involving the Civil Division’s Commercial Litigation Branch, Fraud Section, and the U.S. Attorney’s Office for the District of New Jersey, with support from HHS-OIG. Senior Trial Counsel Christopher Terranova of the Civil Division’s Commercial Litigation Branch (Fraud Section) and Assistant U.S. Attorney Kruti Dharia for the District of New Jersey handled the settlements.
Government’s Pursuit of Healthcare Fraud
The U.S. government’s pursuit of matters like these demonstrates its commitment to combating healthcare fraud.
The False Claims Act serves as a powerful tool in this effort. Individuals and entities can report potential fraud, waste, abuse, and mismanagement to the Department of Health and Human Services.
Disclaimer: Allegations and No Determination of Liability
It’s essential to note that the claims resolved by these settlements are allegations, and no determination of liability has been made at this stage.