Two whistleblowers who alleged that a Philadelphia-based vascular health company and several of its subsidiaries were cheating Medicare and engaging in illegal kickback schemes have helped the U.S. recover more than $3.8 million.
The whistleblowers filed separate lawsuits alleging Vascular Access Centers LP and 23 of its subsidiary companies violated the federal False Claims Act and Anti-Kickback Statute, both of which are intended to protect U.S. taxpayer money from being squandered and misspent.
The U.S. Department of Justice investigated the whistleblowers’ claims and chose to intervene, thereby taking over their litigation. ‘
According to the Justice Department, Vascular Access Centers and the other defendants will pay the U.S. $3,825,000 to resolve allegations that they billed Medicare for non-reimbursable vascular access procedures performed on beneficiaries with End Stage Renal Disease. Federal prosecutors said that the defendants failed to provide Medicare with the required medical documentation supporting the necessity of the procedures.
The settlement also resolves whistleblower allegations that Vascular Access Centers submitted false claims to Medicare for services that resulted from referrals that the company had induced through improper kickback payments to physician investors and medical directors. The purpose of the Anti-Kickback Statute is to ensure that the medical judgment of physicians is not compromised by improper financial incentives and is instead based on the best interests of the patient.
The U.S. Justice Department indicated that the settlement amount is a bare minimum that Vascular Access Centers will be required to pay in a series of fixed payments over five years. However, the defendants could end up paying more than $18 million if certain terms are not met.
The settlement also requires that the company enter into a Corporate Integrity Agreement with the Department of Health and Human Services’ investigative arm. The agreement requires Vascular Access Centers to take certain measures over the next five years to ensure its compliance with federal regulations.
“Medicare fraud hurts not only patients and honest practitioners, but all taxpayers who pay hard-earned dollars into the nation’s public fisc,” said U.S. Attorney Peter G. Strasser. “The favorable resolution of this False Claims Act matter illustrates our firm commitment to use all available remedies, both civil and criminal, to attack health care fraud at its source.”
The whistleblowers whose False Claims Act lawsuits led to the settlement will share an award of at least $612,000.