Radiation Therapy Company Agrees to Pay Up to $11.5 Million to Settle Allegations of False Claims and Kickbacks
Whistleblower to be Paid $1.7 Million from the Recovery
Seattle Whistleblower Attorneys report that SightLine Health LLC (SightLine), which operates radiation therapy centers throughout the United States, has agreed to settle a False Claims Act lawsuit alleging that it knowingly submitted claims to the Medicare program that violated the Anti‑Kickback Statute. Together with Integrated Oncology Network Holdings LLC (ION), which acquired SightLine in 2011, SightLine has agreed to pay the government up to $11.5 million.
The Anti-Kickback Statute is intended to ensure that a physician’s medical judgment is not compromised by improper financial incentives and instead is based on the best interests of the patient. It prohibits anyone from offering, paying, soliciting, or receiving remuneration to induce referrals of items or services covered by Medicare, Medicaid, and other federally funded programs. Claims submitted in violation of the Anti-Kickback Statute may subject the claimant to liability under the False Claims Act.
The settlement announced today resolves allegations that SightLine violated the Anti-Kickback Statute and the False Claims Act by targeting physicians that were able to refer patients to its cancer treatment centers, and paid those physicians a share of its profits pursuant to investment arrangements that were set up to allow physicians to profit from their referrals. Specifically, the United States alleged that SightLine formed a series of leasing companies in which referring physicians were permitted to invest, and through which SightLine allegedly distributed the profits that its physician-investors generated by referring cancer patients for radiation therapy.
The allegations resolved by the settlement were brought in a lawsuit filed under the qui tam, or whistleblower, provisions of the False Claims Act. The act permits private parties to sue on behalf of the government when they believe that defendants submitted false claims for government funds and to share in any recovery. The act also allows the Government to take over the case, as it did here in part. The whistleblower will receive up to $1.725 million.
The case is captioned United States ex rel. IIRT, LLC v. Sightline Health LLC, et al.., Civil Action No. 3-15CV-3202N (N.D. Tex.). The claims resolved by this settlement are allegations only and there has been no determination of liability.
Source: Dept. of Justice
The Anti-Kickback Statute is intended to ensure that a physician’s medical judgment is not compromised by improper financial incentives and instead is based on the best interests of the patient. It prohibits anyone from offering, paying, soliciting, or receiving remuneration to induce referrals of items or services covered by Medicare, Medicaid, and other federally funded programs. Claims submitted in violation of the Anti-Kickback Statute may subject the claimant to liability under the False Claims Act.
The settlement announced today resolves allegations that SightLine violated the Anti-Kickback Statute and the False Claims Act by targeting physicians that were able to refer patients to its cancer treatment centers, and paid those physicians a share of its profits pursuant to investment arrangements that were set up to allow physicians to profit from their referrals. Specifically, the United States alleged that SightLine formed a series of leasing companies in which referring physicians were permitted to invest, and through which SightLine allegedly distributed the profits that its physician-investors generated by referring cancer patients for radiation therapy.
The allegations resolved by the settlement were brought in a lawsuit filed under the qui tam, or whistleblower, provisions of the False Claims Act. The act permits private parties to sue on behalf of the government when they believe that defendants submitted false claims for government funds and to share in any recovery. The act also allows the Government to take over the case, as it did here in part. The whistleblower will receive up to $1.725 million.
The case is captioned United States ex rel. IIRT, LLC v. Sightline Health LLC, et al.., Civil Action No. 3-15CV-3202N (N.D. Tex.). The claims resolved by this settlement are allegations only and there has been no determination of liability.
Source: Dept. of Justice