The provider allegedly billed Medicare for non-reimbursable procedures, and offered improper remuneration to physician investors and medical directors.
Philadelphia-based Vascular Access Centers L.P. and its 23 subsidiaries in eight states will pay at least $3.8 million to resolve False Claims Act allegations involving kickbacks for referrals, the Department of Justice said.
Federal prosecutors alleged that VAC violated the False Claims Act by billing Medicare for non-reimbursable vascular access procedures performed on end stage renal disease beneficiaries and that the company used kickbacks to entice referrals for the procedures.
"Medicare patients with end stage renal disease, like other beneficiaries, are entitled to receive care in accordance with their clinical needs and not based on the financial interests of healthcare providers," DOJ Civil Division Assistant Attorney General Joseph H. Hunt said.
HealthLeaders' calls to VAC were not returned.
VAC allegedly billed Medicare for vascular access surgical procedures performed on ESRD beneficiaries, including fistulagrams and percutaneous transluminal angioplasties, without all of the required supporting medical documentation.
The settlement also resolves Anti-Kickback Statute allegations that VAC submitted false claims to Medicare for services from referrals that VAC had induced through improper remuneration to physician investors and medical directors.
VAC agreed to pay a minimum of $3.8 million in a series of fixed payments over five years, and could pay up to $18.3 million if contingencies in the settlement are triggered.
VAC has also entered into a five-year Corporate Integrity Agreement with the Department of Health and Human Services Office of Inspector General that will focus on VAC's arrangements with physicians and other providers.
The settlement resolves whistleblower allegations brought in two lawsuits. The whistleblowers will collectively receive at least $612,000 as their share of the settlement.
John Commins is the news editor for HealthLeaders.
KEY TAKEAWAYS
VAC allegedly improperly billed Medicare for vascular access surgical procedures performed on ESRD beneficiaries.
The company submitted false claims to Medicare for services from referrals induced through improper remunerations.