The settlement addresses the claim that Respironics gave DME suppliers illegal inducements, causing them to submit false claims for respiratory-related medical equipment
U.S. Department of Justice headquarters. (Credit: w:User:Coolcaesar from Wikipedia)
Philips announced its settlement with the US Department of Justice (DOJ) to pay more than $24m to resolve False Claims Act allegations revolving around kickbacks.
According to DOJ, Philips RS North America, formerly known as Respironics, had misled federal health care programmes by paying kickbacks to durable medical equipment (DME) suppliers.
The impacted programmes include Medicare, Medicaid, and TRICARE, which is the health insurance plan for active military personnel and their families.
DOJ alleged that Respironics gave DME suppliers illegal inducements, causing them to submit claims for ventilators, oxygen concentrators, CPAP and BiPAP machines, and other respiratory-related medical equipment that were fake.
Respironics allegedly provided free physician prescribing data to DME vendors so they could help doctors in their marketing campaigns.
Under the terms of the settlement, Respironics will pay $22.62m to the US and an additional $2.13m to the various states as a result of the impact of Respironics’ conduct on their Medicaid programmes.
The firm also signed a five-year Corporate Integrity Agreement (CIA) with HHS-OIG in addition to the legal settlement.
CIA requires Respironics to create and maintain a comprehensive compliance programme that, among other things, reviews agreements with referral sources and keeps an eye on its sales staff.
In order to evaluate the efficiency of Respironics’ compliance systems, the CIA additionally mandates that Respironics retain an impartial monitor that has been chosen by the OIG.
DOJ Civil Division head Brian Boynton said: “Paying illegal remuneration to induce patient referrals undermines the integrity of our nation’s health care system.
“To ensure that the goods and services received by federal health care program patients are determined by their health care needs, rather than the financial interests of third parties, we will pursue any individual or entity that violates the prohibition on paying kickbacks, including DME manufacturers.”
The Anti-Kickback Statute bans the knowing and wilful payment of any remuneration to persuade the referral of services or items that are paid for by a federal health care programme like Medicare, Medicaid or TRICARE.