A kickback whistleblower lawsuit lodged against Wheeling Hospital and associated medical practice has now been joined by the United States government. This is a False Claims Act kickback whistleblower lawsuit arguing that inappropriate payments and kickbacks were made to physicians.

Businesses are required under the False Claims Act, a federal law, to submit fair and honest claims to government programs like Medicaid and Medicare. When individuals or companies use kickback schemes in order to generate fraudulent claims or additional compensation outside the bounds of the law, a whistleblower might become aware of this information and report it to the government.

Whistleblowers are those individuals who choose to take steps to report fraudulent behavior and receive protections for this activity to report.

The U.S. government may intervene in a kickback whistleblower lawsuit alleging violations of the False Claims Act. A False Claims Act lawsuit is most likely to be brought by a party who has insider knowledge about illegal activities or fraud. As part of the False Claims Act, such a lawsuit might entitle the individual whistleblower to a portion of the funds recovered, whether or not the United States government intervenes.

The government has intervened in a False Claims Act lawsuit alleging that Wheeling Hospital violated the anti-kickback statute and the Stark Law because of actions carried out by the hospital’s CEO and a contracted management consultant.

The lawsuit was originally filed at the end of 2017 by a former vice president for Wheeling Hospital. The kickback whistleblower filed that lawsuit alleging fraud and other violations of the False Claims Act.

Provisions under the False Claims Act enable a private party to sue on behalf of the U.S. government for fraudulent claims made under federal programs, such as Medicare and Medicaid. The U.S. government is eligible to intervene and overtake that lawsuit. Vviolators of the Act might be responsible for applicable penalties and even treble, or triple the amount of damages.

The False Claims Act prohibits paying or offering any items of value to physicians or other medical staff to encourage referral of services or items covered by federal healthcare programs, commonly known as kickbacks.

According to the kickback whistleblower, Wheeling Hospital’s compensation to several different contracted and employed physicians broke these prohibitions because the compensation paid out to those people was based on the value or the volume of the physician’s referrals or, in certain situations, was above fair market value.

The Stark Law referenced in the lawsuit prohibits hospitals and health care facilities for billing Medicare for services that are referred by doctors who have an inappropriate financial relationship with the hospital.

In commenting on the kickback whistleblower lawsuit, an assistant attorney general from the Department of Justice’s Civil Division noted that inappropriate financial arrangements between doctors and hospitals threatened patient safety because it can influence the amount of health care and type of health care that is provided.

The Kickback Whistleblower Lawsuit is Case No. 17-cv-1654 in United States District Court in the Western District for Pennsylvania.