Q3 of 2024 – like many quarters before – brought a smattering of False Claims Act settlements, encompassing a variety of allegations. As we often see, there were several settlements resolving allegations involving violations of the Anti-Kickback Statute.
One of those settlements involved dialysis provider DaVita. DaVita agreed to pay more than $34 million to resolve allegations that it provided illegal remuneration to physicians in exchange for their referrals. The government alleged that DaVita bought a competitor’s dialysis clinics and products in exchange for sending Medicare patient prescriptions to DaVita Rx and that DaVita provided free management services to vascular access centers, all in an attempt to induce physicians to provide referrals of dialysis patients.
Another such settlement involved National Interventional Radiology Partners (NIRP) and its founding physician. NIRP and Dr. Andrew Gomes agreed to pay $8.8 million to resolve allegations that they violated the False Claims Act and Anti-Kickback Statute by illegally paying physicians for referrals to clinics to surgically treat patients with peripheral arterial disease (PAD). Gomes allegedly told investing physicians that if they referred patients to receive revascularization surgery at the facility, the surgical centers would become profitable, and then able to be sold for a profit – resulting in a return on their investment in the clinics.
Oak Street Health marked another settlement, a $60 million settlement resolving allegations that the CVS subsidiary unlawfully compensated third-party insurance agents for making referrals or recommendations of their clients to Oak Street. The government specifically alleged that Oak Street paid insurance agents to contact seniors who were eligible for Medicare Advantage and market Oak Street’s services, referring interested seniors to Oak Street.
Turning away from Anti-Kickback Statute and turning toward improper billing, Walgreen Co. and Walgreens Boots Alliance Inc. reached a $106.8 million settlement, resolving allegations that the company billed government healthcare programs for prescriptions that were never actually picked up by patients. The government alleged that from 2009 to 2020, Walgreens submitted false claims to federal government programs for prescriptions that it processed, but that were never picked up by patients.
Additional False Claims Act settlements from Q3 2024 and beyond are covered here.