Medical Testing Laboratory Owner Sentenced for Payment of Illegal Kickbacks and Federal Tax Evasion
The owner of a Missouri medical testing laboratory was recently sentenced to two years in prison and three years of supervised release. He was also ordered to pay a $100,000 fine and make restitution to Medicare of $525,285 and $751,787 to the Internal Revenue Service (IRS) for filing false tax returns.
Documents presented in court alleged that between 2009 and 2012, the defendant and others of his associates paid illegal kickbacks to doctors and marketers in exchange for blood and urine specimens that they sent or referred to the laboratory. Although the tests were performed, the company violated federal Anti-Kickback law by billing Medicare and Medicaid for testing services involving payment of prohibited kickbacks.
The medical testing laboratory owner owned a pharmacy during the years 2013, 2014, and 2015. He filed false tax returns for those years in which he reported his total income as being $667,500 when he actually received income of $4,545,896 for those years.
Compliance Perspective
Paying or accepting kickback payments to induce referrals or use a particular vendor and then billing for reimbursement from Medicare and Medicaid government healthcare programs may be considered a violation of Federal Anti-Kickball regulations.
Discussion Points:
- Review policies and procedures regarding paying or receiving kickback inducements to use a particular vendor or for referral of services for Medicare and Medicaid beneficiaries.
- Train staff regarding anti-kickback regulations and the inappropriateness of acceptance or payment of kickbacks for services provided to Medicare and Medicaid beneficiaries. Training should include emphasizing the mandatory reporting of any suspected incident to a supervisor or through the Hotline.
- Periodically audit contracts with vendors to determine if there has been any potential kickback activity involving referral of services for Medicare and Medicaid beneficiaries.
FRAUD MODULE 3: MASTERING LEGAL IMPLICATIONS AND ANTI-TRUST LAWS
