Two physicians and an operating room technician filed a whistleblower lawsuit against a group of neurosurgeons and the medical facility where they operated. The whistleblowers accused the medical professionals of falsely inflating the number of spinal surgeries in an effort to increase their earnings and patient referrals. The hospital countered that the practices used were standard throughout the profession. If the whistleblower can support the claim, the allegations result in a violation of the Stark Law and the Anti-Kickback Statute (AKS).
How did the case progress?
The case began in 2012. At that time, the whistleblowers filed the original lawsuit. The United States Government chose to settle claims in 2016, but the whistleblowers pushed to continue moving forward. Initially, the court dismissed this attempt. However, just last month the appellate court decided the case could move forward.
Why would the court allow the case to move forward?
The court’s reasoning for allowing the claim to move forward: the chance to dig in to the evidence it a bit more. The court stated that the case will move forward to discovery. During discovery, both parties have an opportunity to review the evidence and build their case. Depending on the findings, the case may or may not move forward.
What can others learn from this case?
The case provides an example of the complex nature of these disputes. It is unwise to take allegations of a violation of the Stark Law or AKS lightly. Once a federal investigation begins and the allegations move forward, the process can take years to unfold and can result in devastating consequences. Those who face such accusations have options. An attorney experienced in the niche area of these federal health care law claims can review the case and provide guidance, better ensuring a positive outcome.