The federal Anti-Kickback Statute (AKS) is one of the most well-known anti-fraud laws in the country. This criminal statute has a huge impact on the healthcare industry and can affect physicians, executives, lab owners and anyone else that files claims for payment from federal health care programs like Medicare. In a recent example, the United States Department of Justice (DOJ) accused a health records vendor of an AKS violation.
What evidence did the feds have to support the claim?
The prosecution claimed to have evidence the vendor would provide current clients with bonuses and cash equivalent credits to recommend their products to other prospective clients.
It is important to note that the company was recently the subject of an acquisition. The new organization was not part of the original alleged offense but bears liability as the new owner.
How did it end?
The DOJ announced the health records vendor agreed to settle the case. The group agreed to pay almost $4 million to move forward. As part of the agreement, the group does not admit any wrongdoing. Instead, the settlement allows the new ownership to focus on building their services while also avoiding additional litigation.
The case was the result of a whistleblower action. A former worker initiated the claim and stands to gain over $800,000 from the settlement. This is fairly common in these types of cases. Entrepreneurs who run these vendors are wise to keep this in mind. Workers are incentivized to report any concerns. As a result, it is important for business owners to take the time to conduct internal audits and make sure operations are in line with applicable regulations.