OTHER
DA TE
ENTITY
FCA ALLEGATIONS
AMOUNT
A developer of EHR services agreed to pay $18.25 million to resolve allegations that it engaged in three marketing schemes in violation of the AKS that caused providers to submit false claims related to federal EHR incentive payments. The EHR developer allegedly: (1) invited customers and prospective customers to all-expenses-paid “bucket list” events; (2) entered into “Conversion Deals” whereby it paid competitors to refer customers when their products were discontinued, tied to the value and volume of business ultimately converted; and (3) paid fees to customers for each referral that signed up for the product. 159 The former owners of a telemarketing company agreed to pay at least $4 million to settle claims that they used telemarketing to solicit patients to accept compounded drugs even if the drugs were not medically necessary, obtained prescriptions for the drugs and then provided the prescriptions to compounding pharmacies that agreed to pay the telemarketers half of the TRICARE reimbursement for each prescription. The telemarketing company allegedly paid telemedicine providers to issue the prescriptions, often without a patient exam. 160 An ambulance service provider agreed to pay $650,000 to settle allegations that it submitted claims to Medicare for ambulance transports when the patients either did not require ambulance transport or were not qualified for the services. The government also alleged that the provider lacked proper documentation showing the reasons for the ambulance transports. 161 An EHR software developer agreed to pay more than $3.8 million to resolve allegations that it provided its current customers with cash equivalent credits, cash bonuses and percentage success payments in exchange for recommending its product to potential customers and agreeing in writing to not provide negative information about the company’s products, in violation of the AKS. The government alleged the company violated the FCA because the kickback payments rendered false the company’s claims for federal EHR incentive payments. 162
athenahealth, Inc.
1/28/2021
$18.25 million
Jack Lee Stapleton; Jack Hunter Stapleton
$4 million
3/16/2021
Rural/Metro Corporation
$650,000
3/24/2021
CareCloud Health, Inc. f/k/a CareCloud Corporation
4/30/2021
$3.806 million
159 https://www.justice.gov/usao-ma/pr/athenahealth-agrees-pay-1825-million-resolve-allegations-it-paid-illegal-kickbacks. 160 https://www.justice.gov/opa/pr/former-owners-telemarketing-company-agree-pay-least-4-million-resolve-false-claims-act. 161 https://www.justice.gov/usao-mdfl/pr/ruralmetro-corporation-agrees-pay-650000-settle-civil-false-claims-relating-ambulance. 162 https://www.justice.gov/usao-sdfl/pr/miami-based-carecloud-health-inc-agrees-pay-38-million-resolve-allegations-it-paid.
NOTABLE SETTLEMENTS BASS, BERRY & SIMS | 77
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