LOS ANGELES--(BUSINESS WIRE)--Georgia Cancer Specialists, I, P.C. (GCS), one of the largest oncology practices in the United States and an affiliate of Atlanta’s Northside Hospital, has agreed to pay $8 million dollars to the federal government to settle claims of Medicare fraud in what the federal judge presiding over the case called a “sophisticated kickback scheme.”
The settlement is the final chapter of a False Claims Act lawsuit commenced in 2011 by two whistleblowers, nurse Natalie Raven and pharmacist Christy Curtis, filed in federal court in Atlanta. The case is captioned United States ex rel. Natalie Raven et al. v. Amedisys, Inc. et al., 11-cv-0994 (N.D. Ga.)
The United States Department of Justice agreed to award the whistleblowers the maximum 30% whistleblower share for reporting and remediating GCS’s fraud.
The $8 million dollar settlement resolves allegations that GCS solicited and received kickbacks for more than a decade, first from Option Care, an infusion pharmacy and medical equipment provider, and later from Amedisys, a Medicare nursing company. It was alleged that these companies maintained improper financial relationships with referring physicians at GCS.
Option Care and Amedisys paid kickbacks to GCS by providing GCS with free or below market value home health coordination services, either paying the salary of GCS nurses providing such services or furnishing their own nurses to function as dedicated home health coordinators for GCS. These coordination services were valuable to GCS which advertised itself as the only oncology practice in Georgia with home health coordinators. In exchange for these kickbacks, GCS referred its cancer-stricken patients for lucrative services billed by Option Care and Amedisys in violation of the Anti-Kickback Statute and the Stark Law.
Louis J. Cohen, lead counsel for the whistleblowers, stated: “Patients count on their doctors to recommend providers that will do the best job to care for them. Instead GCS exploited vulnerable cancer patients, by selling its lucrative referrals to the highest bidder. The kickback payers were allowed to direct the referrals to themselves or any provider of their choosing even if the cancer patients would have gotten better care elsewhere. Without these brave whistleblowers even more patients would be in the same boat. I’m proud of Ms. Raven and Ms. Curtis for their courage in standing up for patients and for the taxpayers.”
After the whistleblowers filed their lawsuit in 2011 they met with federal investigators and Department of Justice lawyers. In 2014, the United States intervened in the case against Amedisys. Amedisys admitted it may have violated the Stark law and paid $5.7 million dollars in settlement. Amedisys also signed a “Corporate Integrity Agreement,” promising that it would not defraud Medicare.
GCS, however, refused to accept responsibility for soliciting and accepting these kickbacks. The United States left it to Relators and their counsel to prosecute the case against GCS on behalf of the United States.
The case against GCS was litigated by Relators’ counsel, Louis J. Cohen, of Agoura Hills, CA and his co-counsel, G. Mark Simpson, of Fayetteville, GA. Louis J. Cohen, a Professional Corporation, is a California firm with a nationwide practice representing whistleblowers in cases under the False Claims Act. Simpson Law Firm, LLC, represents whistleblowers nationwide in cases under the False Claims Act.
The whistleblowers will receive $2.4 million dollars, the maximum possible relators’ share, as their reward for reporting this conduct to the United States and prosecuting the case on its behalf. The balance of the proceeds, $5.6 million dollars, will be returned to the taxpayers.
The maximum relators’ share obtained in this case is extraordinary. In over 11,000 False Claims Act cases filed since 1986, a 30% share has been awarded less than one percent of the time, and even more rarely in cases worth millions of dollars.
The Relators and their counsel wish to acknowledge Chris Huber, Deputy Chief, Complex Frauds, of the US Attorney’s Office of the Northern District of Georgia, for his steadfast support of this case.
