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Whistleblower to receive $4.9 million in medical kickbacks case

A Texas doctor will receive $4.9 million as a reward for blowing the whistle on seven ambulance industry defendants who allegedly paid kickbacks to municipal entities in several states in exchange for lucrative ambulance business. The alleged kickbacks violated the federal Anti-Kickback Statute, which prohibits offering, paying, soliciting or receiving remuneration in order to induce referrals. The scheme allegedly resulted in false claims being submitted to Medicare and Medicaid, which violated the False Claims Act.

The Department of Justice achieved a settlement with the ambulance industry defendants of over $21 million. Under the False Claims Act, whistleblowers are entitled to a percentage of the total recovery made by the government in cases they initiate.

The allegations involve East Texas Medical Center Regional Healthcare System, Inc., and East Texas Medical Center Regional Health Services, Inc. (the ETMC defendants), along with their affiliated ambulance company, Paramedics Plus, LLC. These companies allegedly provided kickbacks to the Emergency Medical Services Authorities in at least two states in exchange for ambulance business. The scheme also involved political contributions to certain Oklahoma politicians.

"Paramedics Plus paid millions of dollars in illegal inducements over the course of a number of years," said a U.S. Attorney involved in the case. "Sophisticated health care companies do not simply give away millions of dollars to referral sources without expecting something in exchange. Quid pro quo arrangements for the referral of health care business are illegal."

Prior to intervening in the case against the ambulance industry defendants, the Justice Department settled separately with the ETMC defendants and the Emergency Medical Services Authorities, along with the CEO of one of the authorities.

The settlement involves allegations that were investigated by the Department of Justice and other federal agencies, but there has been no determination of liability.

If you work in the healthcare industry, you may be in a position to notice illegal kickbacks or fraud, waste or abuse against federal programs like Medicare and Medicaid. If you are interested in blowing the whistle, you could be entitled to a substantial reward. To protect your rights, discuss your situation with an attorney experienced in False Claims Act and Anti-Kickback Statute cases.

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