Posts Tagged ‘Stark law’

Millennium Labs Settles for $256 Million in Whistleblower Case

Tampa, FL— A James Hoyer law firm client is among several whistleblowers who came forward to expose wrongdoing by Millennium Health, formerly Millennium Laboratories, which led to a $256 million settlement with the United States government. The company was accused of violating the False Claims Act by billing Medicare, Medicaid and other federal health care programs for medically unnecessary lab tests and offering doctors inappropriate incentives for using its services.

The client worked for Millennium in 2012, as an internal auditor with more than 10 years of experience as a medical coder. As a compliance expert, the client quickly noticed discrepancies with the company’s billing practices. The client’s effort to correct the problems fell on deaf ears, which led to the client filing one of the eight False Claims Act whistleblower cases that ultimately led to the settlement.

“Being a whistleblower is never easy,” said James Hoyer Partner Elaine Stromgren, “It takes courage and conviction to come forward, but it is always gratifying to see those efforts lead to a successful resolution for taxpayers.”

A Department of Justice news release, explained the key allegations against Millennium:

“Millennium caused physicians to order excessive numbers of urine drug tests, in part through the promotion of “custom profiles,” which, instead of being tailored to individual patients, were in effect standing orders that caused physicians to order large number of tests without an individualized assessment of each patient’s needs. This practice violated federal healthcare program rules limiting payment to services that are reasonable and medically necessary for the treatment and diagnosis of an individual patient’s illness or injury. The United States also alleged that Millennium’s provision of free point of care urine drug test cups to physicians—expressly conditioned on the physicians’ agreement to return the urine specimens to Millennium for hundreds of dollars’ worth of additional testing—violated the Stark Law and the Anti-Kickback Statute. The Stark Law and the Anti-Kickback Statute generally prohibit laboratories from giving physicians anything of value in exchange for referrals of tests.”

The head of DOJ’s Civil Division said this case should send a message to companies who violate the rules. “We will not tolerate practices such as the ordering of excessive, non-patient specific tests and the provision of inducements to physicians that lead to unnecessary costs being imposed upon our nation’s health care programs,” said Principal Deputy Assistant Attorney General Benjamin C. Mizer.

As part of the settlement, Millennium, which is one of the largest drug testing laboratories in the country, has entered into a corporate integrity agreement (CIA) with the Department of Health and Human Services-Office of Inspector General.

Under the False Claims Act, whistleblowers who expose problems which lead to a successful recovery on behalf of U.S. taxpayers can receive a portion of the recovery as a reward.

 

Ignored Attorney Advice Leads to $237m Whistleblower Verdict

tuomey logoRepresenting a big win for whistleblowers, the Fourth Circuit Court of Appeal recently upheld a $237 million False Claims Act verdict against Tuomey Healthcare System, which some have billed as the “largest ever levied against a community hospital.” Read More…

 

James Hoyer Client Wins Whistleblower of the Year Award

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At TAF Awards ceremony (Pictured L-R): James Hoyer Partner Elaine Stromgren, Elin Baklid-Kunz, Attorney Marlan Wilbanks

James Hoyer Managing Partner Chris Casper was proud to be local counsel, along with lead-counsel Marlan Wilbanks, for Elin Baklid-Kunz, whistleblower in the $86-million dollar Halifax Hospital settlement.  Elin was named the Taxpayers Against Fraud Education Fund Whistleblower of the Year, at an awards ceremony in Washington, D.C.

Upon receiving the award, Elin expressed her sincere gratitude and talked about the often difficult road whistleblowers face to do the right thing.  She said her family and attorneys provided her with incomparable support to help her through the process.

Elin first came to America from Norway as an au pair to learn English and pursue the American dream.  She started working at Halifax in 1994 while pursuing her Masters of Business Administration at Stetson University.  She became Halifax’s Compliance Officer in 2005 and was promoted to Director of Physician Services for Halifax Health Systems in 2008.

As Director of Physician Services, Elin became concerned that Halifax was making improper payments to doctors for referrals, in violation of the Stark Law.  The Stark Law is intended to prevent incentives to doctors which could entice them to make referral decisions based upon financial gain, instead of the patient’s best interest.  Elin also encountered an internal report that indicated Halifax neurosurgeons were performing medically unnecessary surgeries and admitting patients who did not meet admissions criteria.  This led to what she believes were millions of dollars in fraudulent charges to Medicaid and Medicare.   After reporting her concerns to Halifax and having them fall upon deaf ears, Elin felt she had no choice but to file a False Claims Act case on behalf of U.S. taxpayers.

Elin was presented the Whistleblower of the Year award by Cheryl Meads, whistleblower in the $96 million case against GlaxSmithKline which settled in 2010.  Meads commended Elin for her action and  not just standing by when American taxpayers were being defrauded and patients were being harmed.  She ended with a quote from Bobby Kennedy saying, “Few will have the greatness to bend history itself; but each of us can work to change a small portion of events, and in the total; of all those acts will be written the history of this generation.”

We applaud Elin for doing her part to stand on the right side of history.

 

Whistleblower Suit against Children’s Hospital alleges Overpayment of Doctors

All Children’s Hospital in St. Petersburg, Florida, known for its care of sick children and annual telethons, is the focus of a recently unsealed whistleblower lawsuit which alleges the hospital overpaid some of its doctors in violation of federal law.  The case was profiled in this article by the Tampa Bay Times.

Barbara Schubert, who is represented by the James Hoyer Law Firm, is a former employee who worked for the hospital for more than a decade.  She brought the case forward to expose what she believes are violations of the Stark Statute.  The law is intended to prevent doctors from being tempted to do unnecessary tests and procedures as a way to repay their employer for overly generous compensation.

“The hospital, which is an important part of the community and a source of pride, made some mistakes, went beyond what the rules allow and skirted the regulations,” said James Hoyer Attorney Christopher Casper who is on the team representing Schubert. “The folks in this area deserve to know that the facility they contribute to was doing things it should not be doing.” 

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