Pennsylvania cardiologist who sued his former colleagues and UPMC Hamot will receive $6 million as part of the $20.75 million whistleblower settlement.
According to GoEarie, Tullio Emanuele, M.D., claimed Hamot and the other defendant, Medicor Associates Inc., knowingly submitted claims to the Medicare and Medicaid programs that violated the AntiKickback Statute and the Physician Self-Referral Law (the “Stark Law”).
Emanuele practiced with Medicor from 2001 to 2005. He contended that Hamot violated federal law between 2004 and 2010 by submitting claims, primarily to Medicare, while the hospital was paying millions of dollars a year to Medicor, an independent physician-owned group that remains in business.
Emanuele claimed the arrangement was improper, and that its purpose to induce Medicor to refer or recommend the referral of patients to Hamot.
Emanuele claimed Hamot paid Medicor up to $2 million per year under 12 physician and administrative services arrangements that were created to secure Medicor patient referrals. Hamot allegedly had no legitimate need for the services contracted for, and in some instances the services either were duplicative or were not performed. Emanuele also claimed that the contracts pertaining to the medical directorships were flawed because they were not in writing at all times, as federal law requires.
“Federal law prohibits physicians from entering into financial relationships that may affect their medical judgment and drive up health care costs,” Scott W. Brady, the U.S. attorney for the Pittsburgh-based Western District of Pennsylvania, said in the statement.
Also according to the statement: “The Anti-Kickback Statute prohibits offering, paying, soliciting, or receiving remuneration to induce referrals of items or services covered by Medicare, Medicaid and other federally funded programs. The Physician Self-Referral Law … prohibits a hospital from billing Medicare for certain services referred by physicians with whom the hospital has an improper compensation arrangement.”
Jeffrey Newman represents whistleblowers.
