Wednesday, August 3, 2022

You Can't Outrun the Long Arm of the Law


It always amazes me when someone tries to scam the federal government in a healthcare setting.  There are entire governmental entities whose existence is solely based on looking for oddities in the billing numbers.  It amazes me even *more* when those numbers are massive... as in $1.2 billion massive!  

It seems that there was a healthcare system in Texas that was running a huge kickback scam between hospitals, labs, and doctors.  The problem is, that when you do that kind of thing and then try and bill federal programs... you are violation of federal laws... and when you violate federal laws, the Department of Justice gets involved.  Two things most of us don't want is either the DOJ or a team from 60 Minutes asking to speak with us.

So I offer today's post as advice to anyone thinking of cooking up some similar scam.  You might get away with it for a while, but when you get that call from the DOJ, things are NOT going to be going your way for 10 or more years; if you get my drift.

The full announcement is here, but this is an interesting part of the indictment.

21 Charged, Including Hospital and Lab CEOs, in Connection with Multistate Healthcare Kickback Conspiracy

$32 Million Paid to Date in Civil Settlements

TYLER, Texas – The Department of Justice announced criminal charges against 36 defendants in 13 federal districts across the United States for more than $1.2 billion in alleged fraudulent telemedicine, cardiovascular and cancer genetic testing, and durable medical equipment (DME) schemes.

In connection with this national effort, the U.S. Attorney’s Office for the Eastern District of Texas has charged 21 individuals, including doctors, laboratory executives, hospital executives, and marketers for their involvement in healthcare kickback and money laundering conspiracies.  Former True Health Diagnostics LLC CEO Christopher Grottenthaler, former Boston Heart Diagnostics Corporation Susan L. Hertzberg, former Rockdale Hospital d/b/a Little River Healthcare CEO Jeffrey Paul Madison, and others are defendants in a False Claims Act lawsuit captioned United States ex rel. STF, LLC v. True Health Diagnostics, LLC, et al., No. 4:16-cv-547 (E.D. Tex.).  Additionally, 33 doctors and healthcare executives have agreed to pay over $32 million in order to resolve False Claims Act allegations for their involvement in the scheme.  The criminal and civil cases allege that the defendants unlawfully enriched themselves by paying and receiving illegal kickbacks in exchange for laboratory referrals. 

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