It's difficult to weigh in on the nonprofit situation without a more fact specific inquiry, but there could certainly be ramifications if they are misrepresenting their nonprofit status to government entities and/or tax authorities. The other issues you referenced may give rise to issues under the Stark Law/Anti-Kickback Statue.
The Anti-Kickback Statute,
42 U.S.C. § 1320a-7b(b), extends to all medical providers in a position to arrange or recommend medical services. “Referrals” under the Anti-Kickback Statute include “any item or service for which payment may be made in whole or in part under a Federal health care program.” While the Anti-Kickback Statute covers a broad range of activity, it also requires a showing of an “intent to induce referrals.” Claims for payment submitted to Medicare or Medicaid that include items or services resulting from a violation of the Anti-Kickback Statute are deemed to be false claims under the
False Claims Act, even if the defendant did not have the specific intent to commit a violation of the Anti-Kickback Statute.
Therefore, providers may not argue that they did not know they were violating the FCA because they were not aware the Anti-Kickback Statute existed. Our law firm has compiled a list of informational resources relating to the Anti-Kickback Statute that may be of interest to you:
https://constantinecannon.com/pract...r-types/healthcare-fraud/anti-kickback-stark/.
The information contained herein is for informational purposes only and is not legal advice or a substitute for legal counsel. Online readers should not act upon this information without seeking professional counsel. If you would like more information, or would like to speak to a member of Constantine Cannon’s whistleblower lawyer team, please contact us for a Confidential Consultation:
https://constantinecannon.com/practice/whistleblower/team/.
