Stark Law Violated in Hospital Suit

A 2010 ruling has revealed that Tuomey Healthcare violated the Stark Law when it provided large rewards to physicians that referred their patients to medical facilities owned by Tuomey. The U.S. government took up the role of plaintiff for the case at the behest of Dr. Michael Drakeford and a Stark Law attorney he consulted, following several physicians working under Tuomey were referring patients to the Tuomey Outpatient Surgery Center in exchange for financial kickbacks.

The Stark Law details that physicians cannot self-refer patients for other procedures and tests, and the law also maintains that referral to another medical facility where the doctor has a financial interest would be a violation as well. Since Tuomey was giving these physicians business, and the referred patients underwent treatment that was higher than the normal market value, the court found Tuomey guilty of a Stark Law violation, although jurors held that the False Claims Act was not violated. The False Claims Act is reserved for businesses that fraudulently bill the government for goods or services, so billing the government through Medicaid and Medicare claims could have meant that Tuomey had committed a crime of this nature, as well.

While the jury did not believe Tuomey Healthcare had broken the law under the False Claims Act, they did rule that the government would receive damages for actions that fell under the Stark Law. One Stark Law attorney said that the government was originally seeking $277.5 million from Tuomey for violations of both laws, but that they would still seek a large amount of damage compensation based on the ruling.

In cases where a patient or health care professional believes that a physician may have had a vested interest in referring people for treatment, consulting a Stark Law attorney is always the best option. A specialized Stark Law attorney will be able to inform the person if the rights of patients may have been violated if their physician recommended another treatment or doctor out of self-interest, or if the government had been fraudulently billed as a result of these actions. Additionally, a Stark Law attorney can inform the individual if they are entitled to a portion of any damages awarded from the case in order to protect them from potential consequences of whistleblowing.


May 9th, 2011