The United States government has initiated a lawsuit against Modern Vascular Corporate and its associates, alleging them of illegal conduct and fraudulent activities related to their outpatient-based labs (OBLs) across the country. This lawsuit is significant as it pertains to patient safety and proper use of Medicare and TRICARE funds. The following is a breakdown of the key allegations in the lawsuit that potential victims and interested parties should be aware of.
Allegations of Kickback Schemes
The crux of the government’s claim is that Modern Vascular Corporate, along with its CEO Yury Gampel and other individuals, violated the Anti-Kickback Statute (AKS). AKS is a federal law designed to prevent corruption in the healthcare sector. It prohibits offering, paying, soliciting, or receiving remuneration to induce referrals of items or services covered by federally funded programs.
The government alleges that Modern Vascular Corporate sought out physician-investors who could refer patients to their vascular surgeons. These physicians were offered a low-cost ownership interest in a Modern Vascular OBL. According to the lawsuit, these investments were a form of kickbacks. It is also alleged that the company tracked referrals by these physicians and pressured them to refer more patients.
Questionable Medical Practices
The lawsuit also points to questionable medical practices. The company is accused of aggressively pursuing invasive procedures, which garner higher reimbursement rates, irrespective of the patient’s medical need. Such practices not only potentially exploit Medicare and TRICARE funds, but they also pose a significant risk to patient safety and well-being.
Violations of the False Claims Act
The United States charges Modern Vascular Corporate and associates with violations of the False Claims Act (FCA). The defendants are accused of knowingly presenting false or fraudulent claims for payment to Medicare and TRICARE. Moreover, they are charged with using false records or statements about their compliance with the AKS, leading to more fraudulent claims.
Unjust Enrichment and Payment by Mistake
The government argues that the defendants unjustly benefited from the illicit kickback scheme, asserting that these illicitly obtained payments should be returned. It also contends that payments were made to the defendants under a mistaken understanding of material facts, implying that the defendants misled the government into making these payments.
Seeking Justice
The U.S. government demands a jury trial and seeks damages to be established at trial, trebled as required by law, and civil penalties authorized by law. Furthermore, the lawsuit demands the amount by which the defendants were unjustly enriched and the amounts that were mistakenly paid, all with interest, costs, and expenses.
This lawsuit underscores the importance of adherence to ethical practices in healthcare, transparency, and the proper use of taxpayer dollars. It serves as a stern reminder that fraudulent activities in healthcare will be identified and prosecuted to the fullest extent of the law.
As this case unfolds, potential victims, healthcare professionals, and all other stakeholders should remain vigilant and informed. Stay tuned for further updates on this landmark case.
