Gavel and medical symbol over a map of South Carolina, North Carolina, and Florida, representing a healthcare fraud settlement.

Multi-State Healthcare Fraud Settlement: Doctors, Labs, and Marketers Pay $1.9M in Kickback Scheme

&NewLine;<p><strong>COLUMBIA&comma; S&period;C&period; –<&sol;strong> In a significant crackdown on healthcare fraud&comma; a multi-state settlement has been reached&comma; resulting in over &dollar;1&period;9 million in payments from medical professionals and related entities&period; The Department of Justice announced that Gerald Congdon&comma; M&period;D&period;&comma; of Pawleys Island&comma; South Carolina&semi; Gbenga Aluko&comma; M&period;D&period;&comma; of Charlotte&comma; North Carolina&semi; Anup Banerjee&comma; M&period;D&period;&comma; of Gastonia&comma; North Carolina&semi; and their respective medical practices&comma; alongside Curis Healthcare Inc&period; of Chicago&comma; Illinois&comma; Omar Hussain of South Miami&comma; Florida&comma; and Saeed Medical Group Ltd&period; d&sol;b&sol;a Alliance Immediate and Primary Care of Chicago&comma; Illinois&comma; have agreed to resolve allegations of False Claims Act violations&period; These violations stemmed from their involvement in elaborate laboratory kickback schemes&period;<&sol;p>&NewLine;&NewLine;&NewLine;&NewLine;<p>The settlements&comma; totaling &dollar;1&comma;913&comma;808&comma; underscore the government&&num;8217&semi;s commitment to eradicating fraudulent practices that undermine the integrity of federal healthcare programs&period; A crucial component of the agreement is the parties&&num;8217&semi; commitment to cooperate with the Department of Justice&&num;8217&semi;s ongoing investigations into other potential participants in these alleged schemes&period;<&sol;p>&NewLine;&NewLine;&NewLine;&NewLine;<h2 class&equals;"wp-block-heading">The Anti-Kickback Statute&colon; Safeguarding Patient Interests<&sol;h2>&NewLine;&NewLine;&NewLine;&NewLine;<p>At the heart of this settlement lies the Anti-Kickback Statute&comma; a federal law designed to prevent <a class&equals;"wpil&lowbar;keyword&lowbar;link" href&equals;"https&colon;&sol;&sol;www&period;fraudswatch&period;com&sol;tag&sol;financial-fraud&sol;" title&equals;"financial" data-wpil-keyword-link&equals;"linked" data-wpil-monitor-id&equals;"1302">financial<&sol;a> incentives from compromising medical judgment&period; This statute strictly prohibits offering&comma; paying&comma; soliciting&comma; or receiving remuneration to induce referrals of items or services covered by Medicare&comma; TRICARE&comma; and other federally funded healthcare programs&period; By ensuring that medical decisions are based solely on patients&&num;8217&semi; best interests&comma; the statute plays a critical role in maintaining the ethical standards of the healthcare industry&period;<&sol;p>&NewLine;&NewLine;&NewLine;&NewLine;<h2 class&equals;"wp-block-heading">Details of the Alleged Kickback Schemes<&sol;h2>&NewLine;&NewLine;&NewLine;&NewLine;<p>The <a href&equals;"https&colon;&sol;&sol;www&period;fraudswatch&period;com&sol;medicaid-fraud-dr-ghodrat-pirooz-sholevar-settles-for-900k-after-overbilling-for-mental-health-services&sol;" data-wpil-monitor-id&equals;"1297">settlements specifically address allegations that healthcare<&sol;a> providers received kickbacks in exchange for referring patients to a laboratory located in Anderson&comma; South Carolina&period; Furthermore&comma; the settlements resolve allegations that a marketer and his marketing company received kickbacks from the same South Carolina laboratory for arranging laboratory testing referrals&period; These alleged kickbacks ultimately led to the submission of false or fraudulent laboratory testing claims to Medicare and TRICARE&comma; violating the False Claims Act&period;<&sol;p>&NewLine;&NewLine;&NewLine;&NewLine;<h2 class&equals;"wp-block-heading">Specific Settlement Agreements&colon;<&sol;h2>&NewLine;&NewLine;&NewLine;&NewLine;<ul class&equals;"wp-block-list">&NewLine;<li><strong>Dr&period; Gerald Congdon&comma; Coastal Urgent Care&comma; LLC&comma; and Coastal Wellness Center&comma; LLC&colon;<&sol;strong> Dr&period; Congdon and his medical practices in Pawleys Island and Myrtle Beach&comma; South Carolina&comma; will pay &dollar;400&comma;000&period; Allegations suggest that between May 2016 and November 2021&comma; they received thousands of dollars in remuneration&comma; disguised as office space rental and phlebotomy payments&comma; from the South Carolina laboratory in return for ordering tests&period;<&sol;li>&NewLine;&NewLine;&NewLine;&NewLine;<li><strong>Dr&period; Gbenga Aluko and Eagle Medical Center&comma; PC&colon;<&sol;strong> Dr&period; Aluko and his medical practice in Charlotte&comma; North Carolina&comma; agreed to pay &dollar;250&comma;000&period; The allegations state that from May 2016 to November 2021&comma; they received thousands of dollars in remuneration disguised as office space rental&comma; phlebotomy&comma; and toxicology payments from the South Carolina laboratory in exchange for ordering tests&period;<&sol;li>&NewLine;&NewLine;&NewLine;&NewLine;<li><strong>Dr&period; Anup Banerjee and Gastonia Medical Specialty Clinic P&period;A&period;&colon;<&sol;strong> Dr&period; Banerjee and his medical practice in Gastonia&comma; North Carolina&comma; will pay &dollar;206&comma;000&period; It is alleged that between April 2017 and November 2021&comma; they received thousands of dollars in remuneration disguised as office space rental and phlebotomy payments from the South Carolina laboratory in return for ordering tests&period;<&sol;li>&NewLine;&NewLine;&NewLine;&NewLine;<li><strong>Omar Hussain and Curis Healthcare Inc&period;&colon;<&sol;strong> Hussain and his marketing company agreed to pay &dollar;817&comma;808&period; Allegations indicate that from April 2020 to August 2021&comma; Hussain and his company received commissions from the South Carolina laboratory as independent contractors&comma; based on the volume and&sol;or value of Medicare and TRICARE referrals for laboratory testing that they arranged or recommended&period;<&sol;li>&NewLine;&NewLine;&NewLine;&NewLine;<li><strong>Saeed Medical Group Ltd&period;&comma; Omar Hussain&comma; and Curis Healthcare Inc&period;&colon;<&sol;strong> Saeed Medical Group&comma; along with Hussain and his marketing company&comma; agreed to pay &dollar;240&comma;000&period; It is alleged that between April 2020 and August 2021&comma; Saeed Medical Group received thousands of dollars in remuneration in the form of cash payments from Hussain and his company in return for ordering tests from the South Carolina laboratory&period;<&sol;li>&NewLine;<&sol;ul>&NewLine;&NewLine;&NewLine;&NewLine;<h2 class&equals;"wp-block-heading">Statements from Law Enforcement and Government Officials<&sol;h2>&NewLine;&NewLine;&NewLine;&NewLine;<p>&&num;8220&semi;Integrity must be the standard in our health care system&comma;&&num;8221&semi; stated Acting U&period;S&period; Attorney Brook B&period; Andrews for the District of South Carolina&period; <a href&equals;"https&colon;&sol;&sol;www&period;fraudswatch&period;com&sol;financial-fraud-edward-and-linda-mangano-guilty-on-multiple-counts-of-accepting-bribes-and-kickbacks-in-exchange-for-official-government-action&sol;" data-wpil-monitor-id&equals;"1296">&&num;8220&semi;Kickback schemes<&sol;a> divert funds and focus away from patients and their medical needs&period;<&sol;p>&NewLine;&NewLine;&NewLine;&NewLine;<p>Steve Jensen&comma; Special Agent in Charge of the FBI Columbia field office&comma; emphasized&comma; &&num;8220&semi;The public puts immense trust in medical professionals&comma; and disdain for the rule of law damages that trust and erodes their credibility&period; These settlements should serve as a reminder that the FBI and its partners are committed to holding medical practitioners accountable for kickbacks&period;&&num;8221&semi;<&sol;p>&NewLine;&NewLine;&NewLine;&NewLine;<p>Kelly Blackmon&comma; Special Agent in Charge at the U&period;S&period; Department of Health and Human Services Office of Inspector General &lpar;HHS-OIG&rpar;&comma; added&comma; &&num;8220&semi;Kickback schemes undermine <a href&equals;"https&colon;&sol;&sol;www&period;fraudswatch&period;com&sol;beware-of-medical-equipment-scams-in-2024-stay-informed-protect-yourself&sol;" data-wpil-monitor-id&equals;"1298">medical decision-making and jeopardize the integrity of federally funded health<&sol;a> care programs&period; Our commitment is to safeguard taxpayer-funded health care and the patients who rely on it&comma; and we will rigorously pursue any allegations of False Claims Act violations&period;&&num;8221&semi;<&sol;p>&NewLine;&NewLine;&NewLine;&NewLine;<p>Special Agent in Charge Christopher Dillard of the Department of Defense Office of Inspector General&comma; Defense Criminal Investigative Service &lpar;DCIS&rpar;&comma; Mid-Atlantic Field Office&comma; stated&comma; &&num;8220&semi;The trust of the American taxpayer and the wellbeing of our Service members are undermined when laboratories and physicians engage in collusive financial relationships&period; DCIS will continue to work with our <a href&equals;"https&colon;&sol;&sol;www&period;fraudswatch&period;com&sol;justice-department-leadership-honors-service-and-sacrifice-of-nations-law-enforcement-for-police-week&sol;" data-wpil-monitor-id&equals;"1300">law enforcement partners to bring to justice<&sol;a> medical providers who illegally enrich themselves by prioritizing kickbacks over patient care&period;<&sol;p>&NewLine;&NewLine;&NewLine;&NewLine;<h2 class&equals;"wp-block-heading">Collaborative Effort and Ongoing Investigations<&sol;h2>&NewLine;&NewLine;&NewLine;&NewLine;<p>The settlements resulted from a coordinated effort between the Civil Division’s Commercial Litigation Branch&comma; <a href&equals;"https&colon;&sol;&sol;www&period;fraudswatch&period;com&sol;assistant-attorney-general-matthew-g-olsen-delivers-remarks-at-hoover-institution-announcing-national-security-cyber-section&sol;" data-wpil-monitor-id&equals;"1299">Fraud Section<&sol;a>&comma; and the U&period;S&period; Attorney’s Office for the District of South Carolina&comma; with assistance from HHS-OIG&comma; DCIS&comma; and the FBI&period; Senior Trial Counsel Christopher Terranova and Assistant U&period;S&period; Attorney Beth C&period; Warren handled the settlements&period;<&sol;p>&NewLine;&NewLine;&NewLine;&NewLine;<p>This case follows previous settlements involving physicians in South Carolina&comma; North Carolina&comma; and Texas who received kickbacks from the same South Carolina laboratory&comma; demonstrating the government&&num;8217&semi;s persistent pursuit of healthcare fraud&period;<&sol;p>&NewLine;&NewLine;&NewLine;&NewLine;<h2 class&equals;"wp-block-heading">The False Claims Act&colon; A Vital Tool in Combating Fraud<&sol;h2>&NewLine;&NewLine;&NewLine;&NewLine;<p>The government’s pursuit of this matter underscores its emphasis on combating <a href&equals;"https&colon;&sol;&sol;www&period;fraudswatch&period;com&sol;healthcare-fraud-rafael-chikvashvili-sentenced-for-charges-related-to-a-health-care-fraud-and-wire-fraud-conspiracy&sol;" data-wpil-monitor-id&equals;"1301">healthcare fraud<&sol;a>&period; The False Claims Act is a powerful tool in this effort&comma; allowing individuals to report potential fraud&comma; waste&comma; abuse&comma; and mismanagement&period; Tips and complaints can be reported to the Department of Health and Human Services at 1-800-HHS-TIPS &lpar;800-447-8477&rpar;&period;<&sol;p>&NewLine;&NewLine;&NewLine;&NewLine;<h2 class&equals;"wp-block-heading">Important Disclaimer<&sol;h2>&NewLine;&NewLine;&NewLine;&NewLine;<p>It is crucial to note that the claims resolved by these settlements are allegations only&comma; and there has been no determination of liability&period; This statement emphasizes the importance of due process and the presumption of innocence&period;<&sol;p>&NewLine;&NewLine;&NewLine;&NewLine;<h2 class&equals;"wp-block-heading">Impact on the Healthcare Industry<&sol;h2>&NewLine;&NewLine;&NewLine;&NewLine;<p>This multi-state settlement serves as a stark reminder of the severe consequences of engaging in healthcare fraud&period; It highlights the government&&num;8217&semi;s unwavering commitment to protecting federal healthcare programs and ensuring that patient care remains the top priority&period; The settlements also reinforce the importance of robust compliance programs within healthcare organizations to prevent such violations&period;<&sol;p>&NewLine;&NewLine;&NewLine;&NewLine;<h2 class&equals;"wp-block-heading">Future Implications<&sol;h2>&NewLine;&NewLine;&NewLine;&NewLine;<p>The government&&num;8217&semi;s continued focus on investigating and prosecuting healthcare fraud is likely to lead to increased scrutiny of financial relationships between healthcare providers&comma; laboratories&comma; and marketing companies&period; This increased scrutiny will necessitate greater transparency and adherence to ethical standards within the industry&period;<&sol;p>&NewLine;&NewLine;&NewLine;&NewLine;<h2 class&equals;"wp-block-heading">Call to Action<&sol;h2>&NewLine;&NewLine;&NewLine;&NewLine;<p>Healthcare professionals and organizations are encouraged to review their compliance programs to ensure they are in full compliance with the Anti-Kickback Statute and the False Claims Act&period; Reporting suspected fraud is essential in maintaining the integrity of the healthcare system&period;<&sol;p>&NewLine;&NewLine;&NewLine;&NewLine;<p>By addressing these issues proactively&comma; the healthcare industry can work towards building a more transparent and ethical environment that prioritizes patient care and safeguards taxpayer funds&period;<&sol;p>&NewLine;

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