The U.S. Department of Justice (DOJ) recently announced a settlement with a Missouri neurosurgeon and his fiancée regarding alleged violations of the False Claims Act (FCA) and Anti-Kickback Statute (AKS). The parties agreed to pay $825,000 to settle the case.
The neurosurgeon and his fiancée were accused of receiving impermissible kickbacks from spinal implant companies in exchange for using the companies’ products in surgeries. This practice violates the AKS, which prohibits receiving or soliciting anything of value in exchange for patient referrals for items or services that are reimbursable by federal healthcare programs.
DOJ’s press release reiterated the vital role that the AKS plays in ensuring that the independent medical judgment of providers is not compromised by improper financial incentives and that all medical decisions are based solely on the needs of the patient. This case also serves as an important example and reminder that the government will vigorously pursue whistleblower claims in its effort to combat healthcare fraud. Under the FCA, whistleblowers can file a private cause of action on behalf of the U.S. government and will receive a portion of the recovery or settlement amount.
DOJ indicated that this case took nearly a decade to prosecute and settle after it was brought to DOJ’s attention by a group of whistleblowers, and it involved the cooperation of several federal and state agencies to bring it to a close.
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