Tag Archives: referrals

Alabama-based Lab Pays $24.5 million penalty in kickback scheme

From our friends at PathologyBlawg.com

“Alabama-based Infirmary Health System (IHS), Infirmary Medical Clinics (IMC), Diagnostic Physicians Group P.C. (DPG) and two clinics run by IMC have agreed to pay $24.5 million to settle allegations they violated the Stark Law and Anti-Kickback Statute by engaging in a scheme to compensate physicians for laboratory and radiology referrals… The government alleged IHS, through its subsidiaries and clinics, paid physician-owned DPG ‘a percentage of collections on items and services performed or referred by DPG physicians’ to IHS-affiliated clinics that performed clinical laboratory and diagnostic imaging tests from 2005 to 2011. DPG then compensated individual physicians for their referrals.”

Read more here.

Note from Jeffrey C Lynne:

Cases such as this are, for the time being, prosecuted based upon the fact that Medicare and/or Medicaid was implicated, as the Stark Laws only pertain to these federal health insurance programs. The Federal Anti-Kickback Statute (AKS) is more broad. However, to date, we are not aware whether the federal government, or any state government, has sought prosecution against a provider who only seeks reimbursement from private pay insurance.