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Kickback and Physician Self-Referral

Archive Kickback and Physician Self-Referral Archive

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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.

2009

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.
11-04-2008
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.
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.
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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