An Erie, Pennsylvania, hospital and a cardiology practice have spent $20.7 million to settle allegations they violated federal anti-kickback laws, the Department of Justice said Wednesday.
UPMC Hamot is alleged to have paid Medicor Associates, a physician practice, for patient referrals. Those claims were the submitted to Medicare and Medicaid programs for reimbursement, the Justice Department said.
“Financial arrangements that improperly compensate physicians for referrals encourage physicians to make decisions based on financial gain rather than patient needs,” said Acting Assistant Attorney General Chad A. Readler, head of the Justice Department’s Civil Division
Court documents allege the two violated the Anti-Kickback Statute and the Physician Self-Referral Law, which prohibit receiving money to induce Medicare or Medicaid referrals.
UPMC Hamot paid up to $2 million a year to Medicor Associates between 1999 and 2000, the Justice Department alleged.
A Medicor doctor, Tullio Emanuele, filed a whistleblower lawsuit under provisions of the False Claims Act, which allows private parties to sue on behalf of the government if they believe defendants submitted false claims under for government funds.
The False Claims also allows whistleblowers to share in any recovery. Therefore, Dr. Emanuele will receive $6 million.
This matter was handled on behalf of the government by the U.S. Attorney’s Office for the Western District of Pennsylvania, the Justice Department’s Civil Division, and the Department of Health and Human Services Office of the Inspector General.
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