Healthcare whistleblower case regarding FMV can proceed
The CFO of a healthcare provider blew the whistle on his former employer, alleging it overpaid for a surgery center in order to induce it to refer future business.
Kuzma v. N. Ariz. Healthcare Corp.
The defendants in this qui tam case asked for summary judgment against the plaintiff Relator, who had alleged violations of the False Claims Act as it related to the sale of Surgery and Rehabilitation Centers by the defendants. Relator brought suit against the defendants, alleging they violated the FCA by overpaying the physician-owners of the Summit Center to reward them for past business and to induce future business in violation of the federal Anti-Kickback Statute. The defendants advanced three arguments in favor of summary judgment: (1) the acquisition price paid for the Summit Center was fair market value; (2) Relator had no evidence that the defendants acted with the requisite scienter; and (3) Relator cannot show a causal link between the alleged kickback and the submission of false claims.
U.S. District Court Partially Denies Motion for Summary Judgment Regarding Qui Tam Case on Excess Purchase Price Under the False Claims Act
The defendants in this qui tam case asked for summary judgment against the plaintiff Relator, who had alleged violations of the False Claims Act as it related to the sale of Surgery and Rehabilitation Centers by the defendants. Relator brought suit against the defendants, alleging they violated the FCA by overpaying the physician-owners of the Summit Center to reward them for past business and to induce future business in violation of the federal Anti-Kickback Statute. The defendants advanced three arguments in favor of summary judgment: (1) the acquisition price paid for the Summit Center was fair market value; (2) Relator had no evidence that the defendants acted with the requisite scienter; and (3) Relator cannot show a causal link between the alleged kickback and the submission of false claims.
Physician Compensation and Valuation: Administering Top Tier Treatment
Assessing physician compensation is a critical component in valuing a physician practice. Many external factors, including the COVID-19 pandemic and proposed changes to the Medicare Physician Fee Schedule, have had and will continue to have significant impacts on physician compensation and associated practice valuations. In this discussion, Derek Long and Katie Culver will explain how physician compensation is analyzed in the context of valuation along with various factors that can influence it, both internally and ...
Healthcare industry hit most by FCA in 2016
Over half of the $4.7 billion in settlements and judgments the government recovered in 2016 under the False Claims Act (FCA) were from the healthcare industry. Allegations often revolve around the measurement of the fair market value of physician compensation.