A few short months ago, in the closing days of 2015, the Government announced that Pathway Genomics Corporation (“Pathway”) paid $4 million dollars to resolve kickback allegations against it. In short, Pathway allegedly offered physicians and medical groups up to $20 for each saliva kit they collected and submitted to Pathway. The physicians would then receive tens of thousands of dollars in reimbursements from Pathway. According to the Government allegations, most of the physicians involved in Pathway’s reimbursement program had never ordered the expensive genetic testing before.
The Anti-Kickback Statute, 42 U.S.C. § 1320a-7b(b), prohibits any person or entity from making or accepting payment to induce or reward any person for referring, recommending or arranging for the purchase of any item for which payment may be made under a federally-funded health care program. The statute not only prohibits outright bribes, but also prohibits offering inducements or remuneration that has as one of its purposes the inducement of a physician to refer patients for services that will be reimbursed by a federal healthcare program.
More information for whistleblowers is located at the Nolan Auerbach & White website.