A doctor who worked for a private cardiology practice in Pennsylvania was awarded $6 million from the settlement of his False Claims Act lawsuit that alleged a hospital paid illegal referral fees for patients.
Dr. Tullio Emanuele worked for Medicor Associates Inc., a regional cardiology practice from 2001 to 2005.
He alleged in a qui tam lawsuit that Medicor and the doctors who owned it collected millions of dollars in illegal referral fees from UPMC Hamot, a hospital based in Erie, Pennsylvania that’s now part of the University of Pittsburgh Medical Center.
Medicor and UPMC agreed Wednesday to pay the government nearly $21 million to settle Dr. Emanuele’s False Claims Act lawsuit. He alleged they knowingly submitted claims to the Medicare and Medicaid programs that violated the Anti‑Kickback Statute and the Physician Self‑Referral Law.
(Hamot became affiliated with UPMC after the conduct resolved by the settlement occurred.)
The Anti-Kickback Statute prohibits offering, paying, soliciting, or receiving remuneration to induce referrals of items or services covered by Medicare, Medicaid, and other federally funded programs.
The Physician Self-Referral Law, commonly known as the Stark Law, prohibits a hospital from billing Medicare for certain services referred by physicians with whom the hospital has an improper compensation arrangement.
“Both the Anti-Kickback Statute and the Stark Law are intended to ensure that a physician’s medical judgment is not compromised by improper financial incentives and is instead based on the best interests of the patient,” the DOJ said.
Under the qui tam or whistleblower provisions of the False Claims Act, private parties can sue on behalf of the government and share in any recovery.
In his lawsuit, Dr. Emanuele alleged that from 1999 to 2010, Hamot paid Medicor up to $2 million a year for patient referrals.
The payments were made under an allegedly bogus services contract between Medicor and Hamot.
Dr. Emanuele is now based in Bowling Green, Kentucky.
The case was United States ex rel. Emanuele v. Medicor Associates, Inc. et al., Civil Action No. 10-cv-00245-JFC (W.D. Pa.).
Richard L. Cassin is the publisher and editor of the FCPA Blog.