A whistleblower claim under the federal anti-kickback statute. has resulted in a $1.5 million settlement, including a reward for the whistleblower.

The owners of Health Quest Inc. have agreed to pay $1.5 million to settle allegations that they violated the anti-kickback statute for marketers to encourage patient referrals. The details of the anti-kickback statute whistleblower settlement were announced by the United States Attorney’s Office.

Based in Palm Beach Gardens, Fla., Health Quest is a home health care company. Multiple arrangements were made while resolving this claim, including a systems review, a transaction review, and a five-year integrity agreement with the Department of Health and Human Services.

When any facility or doctor tries to encourage business by offering incentives or kickbacks, this can force patient care goals to take a backseat in favor of financial goals. Laws are in place that prohibit the use of these kickback agreements so that doctors can make informed decisions based on individual patient factors about whether or not a referral, drug, or medical device is needed.

Despite these laws, some facilities try to use kickback schemes to generate business. Such a scheme might not be discovered until a whistleblower comes forward with inside information about how these plans work. Provisions in place at the federal level aim to encourage whistleblowers to share these details.

According to the anti-kickback statute lawsuit, the company regularly paid out kickbacks to marketers starting in December of 2013 and lasting through May 2017 to encourage those marketers to refer patients directly to Health Quest for home health services. Allegedly, the anti-kickback statute was violated because the payments themselves and these promotions should not have happened. The kickback scheme also put patients in the unfortunate position of being recommended services they might not have needed.

The lawsuit was initiated by a former Health Quest marketer. She filed under the whistleblower provisions of the Federal False Claims Act. The False Claims Act allows private citizens to file a claim on behalf of the government and to receive a portion of the recovery when they have inside information about the alleged fraud.

Furthermore, the False Claims Act enables the government to step in and litigate the lawsuit. The government chose to do so in this anti-kickback case and the whistleblower is now entitled to $300,000 as a result of her report.

Violations of the anti-kickback statute, according to the United States attorneys who commented on the case, lead to medical services that are not in the best interests of patients, frequently unnecessary, and can also drive up the overall cost of health care. The purpose of having the anti-kickback statute is to avoid marketing behavior that aims to increase profits rather than to improve the health of patients.

In many cases, a whistleblower plays an important role in explaining allegations of fraud and indicating evidence that has led them to lodge the lawsuit to begin with. If you or someone you know believes that you have further information about violations of an anti-kickback statute, you need to share your concerns directly with an experienced attorney immediately.

The anti-kickback statute settlement was a joint effort between multiple agencies.

The Anti-Kickback Statute Lawsuit is Case No. 16-81147-CIV-Rosenberg in the United States District Court for the Southern District of Florida.