by Ben Vernia | April 3rd, 2018
On March 29, the Department of Justice announced that Texas-based Sightline Health LLC and its parent will pay up to $11.5 million to resolve a whistleblower’s allegations that the company violated Medicare’s Antikickback Statute. According to DOJ’s press release:
Texas-based 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, the Justice Department announced today. 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.
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The government also announced that the companies have entered into a 5-year corporate integrity agreement with the Office of Inspector General of HHS, and that the qui tam relator will receive up to 1.725 million (a 15% relator’s share).
