Friday, April 18, 2008

Kickback Quandary

Does a $119,000 kickback from a hospital to a referring cardiologist justify the $2.5 million dollar fine the Feds want to impose?
The federal government yesterday filed a civil lawsuit against an Essex County physician, accusing him of participating in an illegal kickback scheme at the University of Medicine and Dentistry of New Jersey, which has already led to the criminal convictions of two other doctors.

According to the suit filed by the U.S. Attorney's Office, cardiologist Atul Prakash of Cedar Grove violated federal Medicare statutes, committed fraud and submitted false statements by illegally referring more than 30 patients to UMDNJ's University Hospital in Newark in return for $119,000 in payments.

The suit seeks triple reimburse ment of Prakash's salary as well as financial penalties that could exceed $2.5 million.

"There are still others who engaged in the same conduct, and we will use both criminal and civil remedies as needed to achieve justice and the return of money received by fraud," U.S. Attorney Christopher Christie said.
I guess it's justified in the government's eyes if they want to pay for even more investigations.

This issue of "self-referral" is a murky one. If payments for referrals is illegal, then why isn't the profit-sharing amongst members of the same large multi-specialty medical group who refer to each other considered a form of kickback? No, this is okay. But when a separate entity like a hospital dares to "profit-share" in return for referrals, it's illegal.

I guess multiple standards can be imposed when the government needs money.


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