When two people become engaged to marry, they pledge themselves to a lifetime of love and companionship. But a federal grand jury has said that a neurosurgeon and his fiancée got much than that out of their relationship.
The pair was found guilty recently of Anti-Kickback Statute violations and submitting false and fraudulent claims to Medicare and Medicaid.
The jury’s decision was handed down after an 11-day civil trial in Missouri, news reports stated. The decision includes an order that the federal Medicare and Medicaid programs recover $1.65 million.
In addition, the defendants face penalties ranging from $5,500 to $11,000 for each of the 228 false claims submitted. That will add up to a penalty of between $1.25 million and $2.5 million, though the exact amount will be determined at a later date by the court.
The case against the pair of defendants was essentially this: the surgeon used spinal implants from his fiancée’s implant distributorship. According to a statement from government attorneys, the fiancée received 50 percent commission on the implants, meaning the doctor’s “treatment choices directly impacted” his future wife’s income.
She then spent some of that income on him, including big ticket items such as a yacht and home improvements.
The financial relationship and “exclusive arrangement” violated the Anti-Kickback Statute, the government argued. Court documents indicated that the surgeon bragged that together the couple earned more than $8 million per year.
A criminal case against the two was dismissed nearly two years ago.
You can discuss safe harbor regulations in the law and more with an attorney experienced in Anti-Kickback and Stark Law litigation.