The Department of Justice has secured a nearly $21 million settlement in an ambulance whistleblower lawsuit over allegations of violations of anti-kickback laws and improper financial relationships.

According to the announcement made by the U.S. Department of Justice, to settle the ambulance whistleblower lawsuit, seven ambulance industry defendants have come to agree to pay the settlement amount over to the government. A whistleblower lawsuit allows private individuals to file under the qui tam provisions of the False Claims Act on behalf of the United States, allowing the government to take part if it so chooses.

According to a DOJ press release, anti-kickback laws are intended to make sure that “medical providers’ judgments are not compromised by improper financial incentives and are instead based on the best interests of their patients.” The Anti-Kickback Statute prohibits healthcare providers from retrieving referrals for services or products covered by programs funded by the government such as Medicaid and Medicare through soliciting and retrieval of remuneration.

The ambulance whistleblower lawsuit was filed in the U.S. District Court for the Eastern District of Texas. The allegations reported accused the company of submitting false Medicaid and Medicare claims in violation of Anti-Kickback laws.

The ambulance whistleblower lawsuit was filed by plaintiff Dr. Stephen D., who alleged that East Texas Medical Center Regional Health Services Inc., East Texas Medical Center Regional Healthcare Systems Inc., and their affiliated ambulance company Paramedics Plus, LLC offered kickbacks to municipal clients in exchange for ambulance service contracts.

Their purpose in allegedly offering kickbacks was to enhance and promote their ambulance business. The DOJ says kickbacks were offered to Pinellas County Emergency Medical Services Authority in Florida, Alameda County, California, and Emergency Medical Services Authority.

As part of the whistleblower settlement agreement, Alameda County and Pinellas EMSA plant to pay the government $50,000 and $66,000, respectively. An additional $5,200 will be paid out to the state of Florida. The government also settled with ETMC Defendants, Paramedics Plus, EMSA, and the company’s former CEO and president. It settled with Paramedics Plus for $300,000 and EMSA for $20.649 million.

According to the Acting Assistant Attorney General, “The United States’ efforts in this case ended abusive practices in the ambulance industry.” He added that, “These settlements demonstrate our commitment to ensuring that health care decisions are made based on patient needs, not a health care provider’s financial interests.”

According to the U.S. Attorney for the Eastern District of Texas, “Paramedics Plus paid millions of dollars in illegal inducements over the course of a number of years.”

He also added that the company’s former CEO and president “allegedly received gifts and also directed Paramedics Plus to make political contributions to local Oklahoma politicians, which EMSA count not do on its own. Sophisticated health care companies do not simply give away millions of dollars to referral sources without expecting something in exchange. Quid pro quo arrangements for the referral of health care business are illegal.”

The whistleblower’s allegations were investigated by the Civil Division of the U.S. Department of Justice, the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), the U.S. Attorney’s Office for the Eastern District of Texas, and the States of California, Indiana, Florida, and Oklahoma.