Financial incentives and rewards paid to doctors for ordering tests and other procedures on patients are at the heart of a Medicare fraud and whistleblower case settled for $24.5 million in Alabama.  The whistleblower, Dr. Christian Heesch, alleged in the suit that Infirmary Health of Mobile, Alabama and three affiliated clinics were improperly paying incentives to induce doctors to order tests reimbursed by Medicare and other federal health programs.

Compensation schemes that financially reward a doctor for ordering tests and other procedures done on patients can violate the Stark Law, officially known as the Physician Self-Referral Act, which limits referrals of Medicaid and Medicare patients and is intended to ensure that a doctor's medical judgment is not tainted by improper financial incentives.

The whistleblower, Dr. Heesch, sued under the federal False Claims Act, which allows private citizens to act on behalf of the government and share in recovery. Dr. Heesch will receive $4.41 million of the settlement. 

Source: Alabama Today

Lexington, Kentucky Medicare fraud lawyer Robert Abell represents whistleblowers in False Claims Act cases; contact him at 859-254-7076. 

Be the first to comment!
Post a Comment