Abbott Laboratories is a well-known, repeat offender of rules and regulations enforced by the federal False Claims Act (“FCA”). The FCA prohibits those in the medical industry from submitting claims to any government healthcare agency if those claims were derived improperly. Improper claims could include those from patients retained through a kickback scheme or for the prescription of certain drugs for uses not intended or approved by the FDA.
Under applicable anti-kickback provisions, claims for reimbursement are considered ineligible if the medical service was performed on a patient referral derived as part of a kickback scheme with a medical services or pharmaceutical corporation. If this sort of fraud is uncovered, all parties involved could face up to triple damages for each unlawful submission of an ineligible invoice.
Details of FCA Case Against Abbott
Abbott Laboratories has agreed to pay $5.475 million in order to avoid prosecution for violations of the FCA. The facts of the case involve an unlawful kickback scheme involving several physicians who were offered lucrative incentives in exchange for purchasing and ordering Abbott’s carotid, biliary and peripheral vascular products.
More specifically, doctors were promised paid positions in teaching and training programs, consulting arrangements and the opportunity to offer speaking engagements. Under the FCA, any invoice for services involving these vascular products procured pursuant to this illegal scheme should have been denied by Medicare or Medicaid for being in violation of the FCA and several anti-kickback statutes.
Policy Behind Anti-Kickback Laws
At first blush, these punishments may seem to be an unlawful intrusion into the parties’ freedom of contract – a right guaranteed under the Constitution allowing Americans to form business agreements without unnecessary government intrusion. However, this freedom is not without exception, and Congress has consistently maintained a policy against any corporate contracts circumventing public policies or relying on the vulnerability of others to succeed.
Here, as reiterated by the Department of Justice, the FCA seeks to eliminate the unlawful intrusion on the right of a patient to unilaterally choose his own doctor, hospital and treatment plan without unwarranted influence by an undisclosed, backroom agreement between the doctor and a medical device company. As stated by Derrick L. Jackson, Special Agent in Charge at the U.S. Department of Health and Human Services, Office of Inspector General in Atlanta:
“[o]ffering financial inducements can distort health care decision-making….OIG and our law enforcement partners vigilantly protect government health programs from such alleged abuses.”
Help Protect Others From Similar Schemes
When doctors refer patients to certain hospitals or specialists, based not on their recommendation and experience, but pursuant to a background kickback scheme, those patients lose their right to individualized, independent care. If you are aware of a similar scheme at your place of employment, we encourage you to meet with an experienced whistleblower attorney right away.
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