Consumer Fraud

Nashville Physician, Lab To Pay $9.35 Million To Settle False Claims Act Kickback Allegations

whistleblower 5 370x210 Nashville Physician, Lab To Pay $9.35 Million To Settle False Claims Act Kickback AllegationsA Nashville physician who formerly  owned a drug testing lab laboratory and that lab’s successor have agreed to pay $9.35 million to settle a False Claims Act (FCA) lawsuit filed by a whistleblower accusing  the defendants of violating the Anti-Kickback Statute and Stark Law in addition to submitting false claims for certain cancer tests.

The lawsuit, which the federal government actively joined, alleged that Dr. Jonathan Oppenheimer, the former owner and CEO of Prost-Data, Inc., which did business as OURLab and was purchased by OPKO Lab LLC in 2012, engaged in kickback schemes that made profits a priority over patient care.

Arrangements built around improper financial incentives and unlawful kickbacks amounted to Dr. Oppenheimer and OURLab submitting false claims for reimbursement to the Medicare Part B program, the lawsuit contended. Federal prosecutors said the alleged kickback schemes ran from June 2007 to January 2015.

“This laboratory traded physicians free computer software for patient referrals,” said U.S. Department of Health and Human Services Special Agent Derrick L. Jackson. “Such quid pro quo arrangements are kickbacks that stifle competition and steer business to the company offering the inducements.”

The settlement also resolves allegations that OURLab/OPKO Lab billed the Medicare and TRICARE programs for certain types of fluorescence in situ hybridization, or “FISH,” tests used for detecting some cancers, despite the tests being ineligible for federal reimbursements.

According to the U.S. Justice Department, the complaint was filed on behalf of the U.S. government by a former OURLab employee. Whistleblowers whose False Claims Act lawsuits end in a financial recovery for the U.S. are awarded between 15 and 30 percent of the total amount recovered. The whistleblower in this case will receive $1.68 million – about 18 percent of the total settlement amount.

Source: U.S. Department of Justice