A former university physician filed a lawsuit on behalf of the U.S. government alleging violations of the False Claims Act. The whistleblower worked for a university affiliated with Detroit Medical Center, which operates several inpatient and outpatient facilities.
According to the Justice.gov website, the whistleblower’s complaint revealed a history of kickbacks to referring physicians. The lawsuit brought attention to DMC’s practice of providing the services of their mid-level nurses and practitioners to a group of 13 doctors.
Kickbacks for referrals could result in charges
The U.S. Anti-Kickback Statute forbids offering rewards in exchange for certain types of patient referrals. As noted on the HHS.gov website, kickbacks may include benefits such as health care services, rent or supplies. Charges could result when kickback referrals involve patients relying on the federal government to pay their medical expenses.
The whistleblower revealed how the 13 doctors received professional services from DMC licensed practitioners at no cost or below their fair market value. The DMC employees provided their professional skills in exchange for the 13 doctors referring Medicare patients to DMC-owned facilities.
Settlement leads to a whistleblower’s award
As a result of the whistleblower’s claim, a settlement required DMC to pay the government $29.7 million for providing service-related kickbacks in violation of the False Claims Act. Under the terms of the settlement, DMC faced no requirement to admit any liability or wrongdoing.
As reported by the Detroit Free Press, the whistleblower received a $5.2 million award for filing a complaint leading to a financial settlement. Whistleblower provisions under the False Claims Act encourage employees to file complaints when they discover health care kickbacks.