By: Christopher A. Parrella, Esq., CPC, CHC, CPCO
Parrella Health Law, Boston, Ma.
A Health Law Defense and Compliance Firm

In a significant enforcement action by the U.S. Department of Justice’s commitment to combating healthcare fraud, two laboratory marketers, five physicians, and their associated companies have agreed to pay over $1.5 million to settle allegations of engaging in illegal kickback schemes. The settlements, arising from activities spanning several states highlight the issue of kickbacks in the healthcare sector and the legal ramifications.

George Carralejo of California, Michael Jeresaty of South Carolina, and their marketing firms, alongside Dr. Paul Bierig of Texas, Dr. Mohd Azfar Malik of Missouri, Dr. Robert Ain of Kansas, and Drs. Barry and Rachel Feinberg of Missouri, were implicated in schemes that violated the Anti-Kickback Statute (AKS) by manipulating referrals for laboratory tests. The AKS, in a nutshell, seeks to ensure medical judgment remains unclouded by prohibiting the exchange of remuneration for referrals of services covered by federally funded healthcare programs. According to the Department of Justice, these individuals and entities orchestrated complex arrangements where physicians were purportedly paid kickbacks disguised as various forms of compensation, such as medical director fees, in exchange for their referrals to certain clinical laboratories. These referrals led to the submission of false claims to Medicare, inflating costs to the taxpayer-funded program and undermining the integrity of medical decision-making.

The Importance of Compliance
This case serves as a stark reminder of the critical importance of compliance with federal healthcare laws. It underscores the need for healthcare providers, marketers, and laboratories to exercise due diligence in their business arrangements to avoid violating the AKS. Healthcare entities must ensure that their compensation structures and referral practices are transparent, fair, and, above all, compliant with legal standards. The settlement also emphasizes the role of whistleblowers in uncovering and addressing fraud within the healthcare system. Individuals who witness unethical practices play a crucial role in bringing these issues to light, helping to safeguard the integrity of healthcare services and the proper use of taxpayer funds.

Legal Guidance and Support
At Parrella Health Law, we understand the complexities of navigating healthcare law and the paramount importance of maintaining compliance with statutes like the AKS. Our firm is dedicated to providing healthcare providers, marketers, and laboratories with the legal guidance necessary to establish compliant practices and avoid the pitfalls of kickback schemes. Our team of healthcare law experts can assist in reviewing and structuring business arrangements, conducting compliance audits, and developing policies and procedures that reinforce ethical practices and legal adherence. By proactively addressing potential compliance issues, healthcare entities can focus on delivering quality care without the looming threat of legal entanglements. Please call us at 857-328-0382 or email us at info@parrellahealthlaw.com

As healthcare law professionals, Parrella Health Law is committed to supporting our clients in upholding these standards, ensuring their practices not only meet but exceed the expectations for integrity and compliance in the healthcare industry.

Christopher Parrella, ESQ, CPC, CHC, CPCO, is the founding partner of Parrella Health Law in Boston, Mass. The firm focuses exclusively on healthcare defense and compliance matters. Chris also travels the country on behalf of a wide range of healthcare organizations, lecturing on a variety of health care enforcement and compliance topics. Chris is one of a handful of health care attorney’s that are also Certified Professional Coders (CPC) and is a member of the AAPC’s National Legal Advisory Board and Ethics Committee.  He is also a Certified Professional Compliance Officer (CPCO) and Certified in Health Care Compliance (CHC.)