Missouri - Texas - Physicians - Medical Practices - Pay $525K

Missouri – Texas – Physicians – Medical Practices – Pay $525K

Chesterfield, and St. Louis Missouri and Texas Physicians and Medical Practices Agree to Pay Over $525,000 to Settle Kickback Allegations Involving Laboratory Testing.

(STL.News) Imran Chishti, M.D. and his medical practice, C Care LLC, both of Chesterfield, Missouri; Shamim Justin Badiyan, M.D., of Frisco, Texas, and Psych Care Consultants LLC, of St. Louis, Missouri, have agreed to pay a total of $525,610 to resolve False Claims Act allegations that they received illegal kickbacks in violation of the Anti-Kickback Statute in return for referring patients for laboratory testing. The parties have agreed to cooperate with the Department of Justice’s investigations of and litigation against other participants in the alleged schemes.

“The prohibition against paying or receiving kickbacks is an important safeguard for ensuring the objectivity of medical decisions that affect federal health care beneficiaries,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “We will continue to pursue those who knowingly violate the law and undermine the integrity of our federal health care system.”

The Anti-Kickback Statute prohibits offering, paying, soliciting, or receiving remuneration to induce referrals of items or services covered by Medicare, Medicaid, and other federally funded healthcare programs. The Anti-Kickback Statute is intended to ensure that medical providers’ judgments are not compromised by improper financial incentives and are instead based on the best interests of their patients.

The settlement announced today resolves allegations that Dr. Chishti and his medical practice, Badiyan, and Psych Care Consultants received kickbacks in violation of the Anti-Kickback Statute in return for making referrals to laboratories in New Jersey, Texas, and Florida.

  • Chishti and C Care.  Chishti and his medical practice, C Care, have agreed to pay $125,504 to resolve two allegations.  First, from July 2016 to August 2018, C Care allegedly received thousands of dollars in payments from a purported management service organization (MSO) named Infinity Nine Health Group MSO LLC (Infinity) in return for Dr. Chishti ordering laboratory tests from American Institute of Toxicology Inc. doing business as HealthTrackRx, a clinical laboratory in Denton, Texas, and InHealth Diagnostic LLC doing business as RealLab (InHealth), a clinical laboratory in Dallas. Second, from August 2018 to July 2020, C Care allegedly received thousands of dollars in payments from a purported MSO named Alari Group LLC (Alari) in return for Dr. Chishti ordering laboratory tests from Genesis Reference Laboratories LLC (Genesis), a clinical laboratory in Orlando, Florida, and RDx Bioscience Inc. (RDx), a clinical laboratory in Kenilworth, New Jersey.
  • Badiyan. Badiyan has agreed to pay $182,676 to resolve allegations that, from November 2018 to June 2022, he received thousands of dollars in payments from a purported MSO named Avior Group LLC (Avior) in return for ordering laboratory tests from RDx and Genesis. RDx and Genesis allegedly paid commissions to an independent contractor recruiter, Corum Group LLC (Corum), which used Avior to pay kickbacks to Dr. Badiyan and other healthcare providers in return for their referrals.
  • Psych Care Consultants. Psych Care Consultants has agreed to pay $217,430 to resolve allegations that, from January 2019 to March 2020, it received thousands of dollars in payments from Alari in return for ordering laboratory tests from Genesis and InHealth. Genesis and InHealth allegedly paid commissions to Corum, which used Alari to pay kickbacks to Psych Care Consultants and other health care providers in return for their referrals.

“Kickbacks can undermine the integrity of our health care system,” said U.S. Attorney Philip R. Sellinger for the District of New Jersey.  “Patients should be able to count on their doctors ordering tests and recommending treatment based on what is best for them, and not because they are receiving payments on the side.  We will continue to pursue anyone responsible for unlawful actions that can put at risk the medical decision-making process.”

“Those who participate in the federal health care system are required to obey the laws meant to preserve the integrity of program funds and the provision of appropriate, quality services to patients,” said Special Agent in Charge Naomi Gruchacz of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG).  “Our agency collaborates frequently with our law enforcement partners to investigate parties alleged to violate the Anti-Kickback Statute.”

The settlements were the result of a coordinated effort between the Civil Division’s Commercial Litigation Branch, Fraud Section, and the U.S. Attorney’s Office for the District of New Jersey, with assistance from HHS-OIG.  The settlements announced today were handled by Senior Trial Counsel Christopher Terranova in the Civil Division’s Commercial Litigation Branch (Fraud Section) and Assistant U.S. Attorney Kruti Dharia for the District of New Jersey.  The United States has recovered over $33 million relating to conduct involving MSO kickbacks to healthcare providers, including False Claims Act settlements with three dozen physicians.

The pursuit of these matters illustrates the government’s emphasis on combating healthcare fraud. One of the most powerful tools in this effort is the False Claims Act.  Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement can be reported to the Department of Health and Human Services at 1-800-HHS-TIPS (800-447-8477).

The claims resolved by the settlements are allegations only, and there has been no determination of liability.

SOURCE: U.S. Department of Justice

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