The US Department of Justice announced on December 18, 2020, that Texas Heart Hospital of the Southwest LLP, a partially physician-owned hospital in Plano, Texas, and its wholly owned subsidiary, THHBP Management Company, LLC (collectively, the “Heart Hospital”) made a $48 million settlement of claims they violated:
- The False Claims act
- The Physician-Self Referral Law (Stark Law)
- The Anti-Kickback Statute (AKS)
Stark Law prohibits a hospital from submitting bills to federal healthcare agencies (such as Medicare) for services if the physicians who make the referral to the hospital have a financial relationship with that hospital – unless there’s a valid exception.
The AKS prohibits healthcare entities from offering or paying remuneration (such as money or benefits) to induce referrals for services covered by federally funded programs such as Medicare and Medicaid.
Stark Law and AKS were enacted to help ensure the integrity of the federal healthcare system. Referrals should be made based on the based medical interests of the patient – not the best financial interests of the referrer. Illegal referrals also drive up the medical costs for all patients and cost the American taxpayer a fortune.
Generally, violations of Stark Law or the AKS also qualify as violations of the False Claims Act.
The whistleblower claim
The $48 million settlement was due to the filing of a qui tam False Claims Act case initiated by a whistleblower. – two former physician owners of Heart Hospital. As a financial reward for filing the claim, the two whistleblowers will share $13,920,000 which is about 28% of the recovery.
At the California Law Offices of Stephen A. Danz and Associates, our firm is made up of a team of experienced whistleblower attorneys. We help whistleblowers prepare and file claims with the US Department of Justice with an eye towards persuading the DOJ to intervene. If you’re aware of any type of governmental fraud, please call us at 877-789-9707 or use our online contact form to schedule an appointment. We’ll guide you through the qui tam process. Se Habla Espanol.