The Biden Administration warned the healthcare industry that it would aggressively prosecute fraud cases. The Justice Department is executing on that promise and doing so with great success. Week after week, we read about False Claims Act settlement with multi-million dollar penalties. We barely hear much about healthcare compliance innovation and strategies — the industry is clearly treading water when it comes to proactive compliance efforts.
Here is a summary of some of the more significant enforcement actions in the past few weeks:
Philips RS (formerly Respironics), a manufacturer of durable medical equipment paid of $24 million to resolve False Claims Act violations. Philips paid kickbacks to DME suppliers to increase sales of ventilators, oxygen concentrators, and other respiratory-related medical equipment. Respironics gave DME suppliers physician prescribing data free of charge to assist in their marketing efforts to physicians.
Philips will pay $22.62 million to the United States and $2.13 million to various states. Philips also entered into a five-year Corporate Integrity Agreement with HHS-OIG. The CIA requires Philips to implement a robust compliance program that includes review of arrangements with referral sources and monitoring of its sales force. The CIA requires Philips to retain an independent monitor, selected by the OIG, to assess the effectiveness of Philips’ compliance systems. The investigation was initiated by a whistleblower, who was awarded $4.3...
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