Boston Heart, a clinical diagnostics company, will pay $26.67 million to resolve whistleblower allegations of kickbacks to physicians, according to the U.S. Department of Justice.
The federal government said Framingham, Mass.-based Boston Heart coordinated with Texas hospitals independent marketers to boost patient referrals for the hospitals.
The independent marketers "set up companies known as management service organizations, to make payments to referring physicians that were disguised as investment returns but were actually based on, and offered in exchange for, the physicians' referrals," the Justice Department said.
Prosecutors said Boston Heart helped management service organizations identify physician targets, referred interested physicians to the organizations and participated with the organizations in sales pitches to offer physicians kickbacks. This led to physicians referring patients to the Texas hospitals and Boston Heart for lab tests performed by Boston Heart, which were then billed to Medicare, Medicaid and Tricare, prosecutors said.
The allegations also accuse Boston Heart of directly or indirectly paying processing and handling fees, waiving patient out-of-pocket costs and providing physician practices with in-office dietitians in exchange for physician referrals.
The settlement resolves the kickback allegations, as well as allegations that Boston Heart conspired with the Texas hospitals and others to bill government payers for outpatient laboratory testing for patients who were not hospital outpatients.
The allegations were originally made in two cases filed by whistleblowers.
Since the original allegations, Boston Heart has gotten new leadership, including a new corporate owner, a new board of directors, a chief compliance officer and an experienced management team, according to a company news release.
"We are pleased to put behind us legacy issues relating to qui tam lawsuits dating in some respects as far back as 2012," said Patrick Noland, Boston Heart President since April 4, 2017. "Boston Heart is a very different organization today compared to what it was then and up to two and a half years ago."
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