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DOJ Lawsuit Highlights Stark Law Compliance Risks for Healthcare Providers

The Department of Justice (DOJ) has filed a False Claims Act (FCA) lawsuit against a public health system, alleging Stark Law violations due to excessive physician compensation. The Stark Law prohibits physicians from referring patients to entities they have financial ties to, aiming to prevent fraud and financial conflicts of interest in federal healthcare programs.

This case reflects increased government enforcement against healthcare providers accused of inflating physician pay to drive referrals. If proven, these violations could result in millions in fraudulent Medicare and Medicaid payments.

➡ Read the full article at Becker’s ASC Review (Published August 14, 2024).

DOJ Investigates Public Health System for Stark Law Violations

The DOJ’s lawsuit raises concerns about hospitals and health systems improperly compensating physicians. According to the complaint, the public health system engaged in financial agreements that compromised medical decision-making and misused taxpayer funds.

These allegations are part of a wider trend in FCA enforcement, showing that physician compensation compliance remains a high-risk area for federal scrutiny.

➡ Read the full article at The National Law Review (Published August 14, 2024).

DOJ Sues Erlanger Health System Over Alleged Stark Law Violations

The DOJ’s False Claims Act lawsuit against Erlanger Health System focuses on compliance concerns and claims that hospital leadership prioritized physician relationships over regulatory compliance.

“This was really kind of deep-rooted—that compliance played a very weak sister to keeping referring doctors happy,” said whistleblower attorney Marlan Wilbanks, who represents the case’s whistleblower.

This case is part of a broader DOJ crackdown on healthcare fraud, targeting financial arrangements that could lead to improper billing practices. If violations are confirmed, Erlanger could face major financial penalties and reputational damage.

➡ Read the partial article in Report on Medicare Compliance, Volume 33, Number 28 (Published August 5, 2024).

Gift Cards Central to $13.75 Million False Claims Act Settlement

A $13.75 million False Claims Act settlement was reached in a case alleging that Exact Sciences Corporation and Exact Sciences Laboratories, LLC violated the Anti-Kickback Statute by offering prepaid Visa gift cards to Medicare and Medicare Advantage beneficiaries. The lawsuit, brought by whistleblower Dr. Niles Rosen, claimed that these incentives were used to encourage the return of Cologuard test kits, leading to improper billing of government health programs.

Read more in the Report on Medicare Compliance, dated October 9, 2023.

Marlan Wilbanks Receives Lifetime Achievement Award From Taxpayers Against Fraud Organization

Published on: October 4th, 2023

Marlan Wilbanks Honored for Lifetime of Service to Whistleblower Advocacy In October 2022, Marlan Wilbanks received a prestigious Lifetime Achievement award at the Taxpayers Against Fraud Annual Conference in Washington, D.C. The award recognized his exceptional dedication to fighting fraud, mentoring legal professionals, and educating the public on the False Claims Act. He was presented … Continue reading >>>

Marlan Wilbanks receives HCHS Lifetime Achievement Award

Published on: July 6th, 2022

Marlan Wilbanks Honored with Habersham Central High School’s Lifetime Achievement Award Marlan Wilbanks, a distinguished attorney and advocate for whistleblower rights, was honored with Habersham Central High School’s Lifetime Achievement Award, nearly 43 years after graduating from the school. This prestigious recognition celebrates Wilbanks’ extraordinary contributions to law, public service, and advocacy, highlighting his dedication … Continue reading >>>

Marlan Wilbanks Awarded Lifetime Achievement Award from Daily Report

Published on: June 8th, 2022

Marlan Wilbanks Honored with Lifetime Achievement Award by the Daily Report The Daily Report has recognized Marlan Wilbanks, a leading whistleblower attorney, with a Lifetime Achievement Award for his 35+ years of experience in False Claims Act (FCA) litigation. This prestigious honor highlights Wilbanks’ extraordinary contributions to the legal profession, his tireless advocacy for whistleblowers, … Continue reading >>>

 

Marlan Wilbanks selected as Chairman of UGA School of Law Board of Visitors

Published on: August 29th, 2019

Marlan Wilbanks Named Chairman of the Board of Visitors at UGA School of Law The University of Georgia (UGA) School of Law has announced that Marlan Wilbanks has been appointed as Chairman of the Board of Visitors. In this prestigious role, he will continue his longstanding support of the law school’s mission—to provide a high-quality, … Continue reading >>>

  • Hospital Chain Will Pay Over $260 Million to Resolve False Billing and Kickback Allegations; One Subsidiary Agrees to Plead Guilty
    Click here to read the Department of Justice press release
  • CHS Subsidiary Pleads Guilty to Criminal Fraud Atop $260M Settlement 
    Click here for a HealthLeaders article dated September 26, 2018
  • Health Management Associates Pays $260 Million To Settle Whistleblower Lawsuits
    Click here for a Market Watch article dated September 25, 2018
  • Prime Healthcare, CEO Settle FCA Case for $65M Over Admissions; Accountability Expands 
    Click here for a Report on Medicare Compliance article dated August 20, 2018
  • California’s Prime Healthcare to pay $65 million to settle Medicare fraud lawsuit
    Click here for a Reveal News article dated August 6, 2018
  • Clayton hospital owner to pay $65 million to settle lawsuit alleging fraud
    Click here for the AJC article dated August 3, 2018
  • Hospital Chain Prime Healthcare to Pay $65M to Settle Fraud Claims
    Click here for a Fulton County Daily Report article dated August 3, 2018
  • Prime Healthcare Services and CEO to Pay $65 Million to Settle False Claims Act Allegations
    Click here for an additional report dated August 3, 2018
  • Prime Healthcare Services and its CEO Agree to Pay $65 Million to Settle Medicare Overbilling Allegations at 14 California Hospitals
    Click here for an additional report from the USAO for the Central District of California dated August 3, 2018

Wilbanks & Gouinlock Client in Prime Healthcare $65 Million Settlement Named “Whistleblower of the Year” for 2018

Published on: August 5th, 2018

Whistleblower Karin Berntsen Exposes Prime Healthcare Fraud, Leading to $65M Settlement Karin Berntsen, the Director of Performance Improvement at Alvarado Hospital in San Diego, played a pivotal role in exposing fraudulent billing practices at Prime Healthcare. Alvarado Hospital was operated and controlled by Prime Healthcare, a rapidly expanding hospital chain. Berntsen’s whistleblower False Claims Act … Continue reading >>>

January 29, 2018 – Marlan Wilbanks Weighs in on DOJ Whistleblower Memo

Published on: January 29th, 2018

DOJ Memo on False Claims Act Dismissals: Insights from Marlan Wilbanks A recent Daily Report article highlighted an important memo released by the Department of Justice (DOJ) that outlines new criteria for federal prosecutors when deciding whether to dismiss a False Claims Act (FCA) case in which the government declines to intervene. The memo provides … Continue reading >>>

  • Facing Trial, Wells Fargo Pays $108 Million to Settle Whistleblower Suit
    Click here for Daily Report Article dated August 4, 2017
  • Bibby Lawsuit Alleges Hidden Charges On Veteran Loans
    Click Here for video story by WSBTV, Channel 2, Atlanta, Georgia.
  • Six Banks Pay $161 Million To Settle False Claims Act Charge
    Click Here for Corporate Crime Reporter Article dated November 20, 2012.
  • Wells Fargo Must Face Suit Over Veteran Loans, Judge Says
    Click Here for Bloomberg Article dated November 20, 2012.
  • Wilbanks & Gouinlock Settles $45 Million Dollar Veteran Fraud Lawsuit With Defendant JPMorgan Chase
    Click here for Press Release.
    Click here for Fox 5 Atlanta report on settlement with JP Morgan Chase.
    Click here for Washington Post article dated March 13, 2012.
  • Whistleblower Lawsuit Takes On Banks Nationwide That Cheated Taxpayers, Veterans Out Of Hundreds Of Millions Of Dollars
    Click here for Press Release.
    Click here for Amended Complaint filed July 18, 2011.
    Click here for The Washington Post Article dated October 4, 2011.
    Click here for The Washington Post Article dated October 16, 2011.
    Click here to see the AdvisorOne article dated November 11, 2011.
  • U.S. Department of Justice identifies a W&G case as one of the top five most significant healthcare fraud cases of 2016
    Click here for the U.S. Department of Justice press release dated December 14, 2016.
  • A big sum for Medicaid – and come hard choices
    Click here for a Georgia Health News article by Andy Miller dated October 12,2016.
  • Tenet Healthcare to pay $513 million in kickback case
    Click here for an Atlanta Journal-Constitution article by Carrie Teegardin dated October 3, 2016.
  • Dallas-based Tenet to pay $514 million to settle whistleblower lawsuit
    Click here for a Dallas Morning News article by Sabriya Rice dated October 3, 2016.
  • Tenet to pay millions over fraud scheme in Georgia 
    Click here for a Georgia Health news article dated October 3, 2016.
  • Two former Tenet hospitals plead guilty to Medicaid kickbacks; $514M settlement finalized
    Click here for a Modern Healthcare article by Erica Teichert dated October 3, 2016.
  • Tenet Healthcare to Pay $514 Million to Settle Kickback Allegations
    Click here for a Wall Street Journal article by Melanie Evans dated October 3, 2016.
  • Hospital chain to pay $513 million to settle kickback claims
    Click here for an Associated Press article dated October 3, 2016.
  • Settlement in “Pay-to-Play” Scheme Involving Undocumented Pregnant Women to Exceed $500M
    Click here for an article by Robin McDonald, Daily Report dated August 18, 2016
  • Tenet Healthcare to pay $514 million to Resolve Kickback Allegations
    Click here for an article by Evan Sweeney, fiercehealthcare.com dated August 5, 2016.
  • Tenet Hospital Chain Offers $238M to Settle Kickback Scheme Allegations
    Click here for an article by Robin McDonald, Daily Report dated February 26, 2016
  • Government Intervenes in Lawsuit Against Tenet Healthcare Corp. and Georgia Hospital Owned by Health Management Associates, Inc. Alleging Payment of Kickbacks
    Click Here for the release from the U.S. DOJ.
    GOVT COMPLAINT INTERVENTION for Complaint-in-Intervention filed by the U. S. Department of Justice.
    Govt Complaint in Intervention Exh. 1 – 7 for Exhibits 1-7.
    Govt Complaint in Intervention Exh. 8-18 for Exhibits 8-18.
    Govt Complaint in Intervention Exh. 19-23 for Exhibits 19-23.
    Govt Complaint in Intervention Exh. 24-25 for Exhibits 24-25.

 

  • Dialysis Company Accused Of Giant Medicare Fraud
    Click Here for Anderson Cooper 360/CNN Video Report of November 30, 2012.
  • Wasted Dialysis Drugs To Buoy Profits Alleged In Davita And Gambro Healthcare, Inc. Case
    Dr. Alon Vainer And Daniel Barbir Allege In Lawsuit That Drugs Were Wasted To Buoy Davita Profits
  • Lawsuit Says Dialysis Giants Davita, Inc. And Gambro Healthcare, Inc., Sought Fraudulent Reimbursements For Hundreds Of Millions Of Dollars For Wasted Drugs, According To Atlanta Lawyers Lin Wood And Marlan Wilbanks
    Click here to view press release
  • Davita, Served By UNC’s Roper On Board, Sued
    Click here for Triangle Business Journal article by Jason deBruyn, dated July 26, 2011
  • Davita Cashed In On Waste, Ex-Workers Say 
    Click here for a Modern Healthcare srticle by Joe Carlson, dated July 26, 2011
  • Dialysis Company Accused Of Drug Scam
    Click here for a Columbus Dispatch article by Andrew Pollack, dated July 27, 2011
  • Lawsuit Alleges Fraud At Dialysis Company 
    Click here for bendbulletin.com article by Andrew Pollack, dated July 26, 2011
  • Largest Healthcare Fraud Case in U.S. History Settled, HCA Investigation Nets Record Total of $1.7 Billion
    Click here for the US Department of Justice Press Release dated June 26, 2003
  • U.S. Joins Suit Alleging Fraud by Columbia/HCA Healthcare 
    Click here for a Wall Street Journal article dated December 31, 1998
  • Olsten Corporation and a Subsidiary Agree to Pay $61 Million in Criminal Fines and Civil Damages 
    Click here for the U.S. Department of Justice press release dated July 19, 1999
  • Olsten settles fraud case
    Click here for a CNN Money article dated July 19, 1999
  • Olsten Whistleblower’s Share: $9.8M
    Click here for a Daily Report article dated July 21, 1999
  • Wilbanks & Gouinlock Client Settles Whistleblower Case With $48 Million Settlement
    Click Here for Daily Report dated Wednesday May 15, 2013.
  • Adventist Repays Millions To Medicare
    Click Here for Orlando Sentinel article by Marni Jameson dated March 6, 2013.
  • Adventist Health Can’t Dodge FCA Claim Of ER Overbilling
    Click Here for Law 360 article dated February 20, 2013.
  • Whistleblower Lawsuit Alleges Adventist Hospital Filed Millions In False Claims
    Click here for Orlando Sentinel Article dated August 8, 2012.
  • JPMorgan Chase to Pay $614 Million for Submitting False Claims for FHA-insured and VA-guaranteed Mortgage Loans 
    Click here for the U.S. Department of Justice press release dated February 4, 2014
  • JPMorgan Chase Settles Whistleblower Lawsuit Alleging Fraud in Veteran Loans for $45 Million 
    Click here for PR Newswire article dated March 13, 2012
  • JPMorgan settles military veterans mortgage lawsuit for $45M
    Click here for Housingwire article dated March 13, 2012
  • JPMorgan Pays Feds $45M in Loan Fraud Settlement 
    Click here for Law 360 article dated March 13, 2012