On January 21, the United States Department of Justice (DOJ) announced a $4.9 million settlement between LiveCare Inc. and the United States to resolve allegations of violating the Anti-Kickback Statute and False Claim Act. LiveCare Inc., a healthcare company located in Venice, Florida, was accused of illegally paying a marketing company to provide patient referrals for its Medicare-sponsored services—specifically remote patient monitoring (RPM) for Type 2 diabetes.
This type of fraud is commonly called “kickbacks,” which is the improper payment of something of value in exchange for a patient’s referral or the use of medical services. In this instance, LiveCare Inc. allegedly paid a third party to generate patient referrals to use their RPM services, even if they were unnecessary. Subsequently, federal healthcare programs such as Medicare reimbursed LiveCare Inc. for these allegedly ill-gotten services.
“Kickback schemes waste valuable Medicare funds and undermine the integrity of medical decision-making,” said Acting Special Agent in Charge Ricardo M. Carcas of the Department of Health and Human Services Office of Inspector General (HHS-OIG). Carcas also vowed that the HHS-OIG will continue to “thoroughly investigate health care fraud,” while also stressing that allegations of fraud regarding RPM services is an “emerging area.”
The settlement came from an whistleblower claim filed under the False Claims Act’s qui tam provisions, where private individuals have the right to file lawsuits on behalf of the federal government and receive a share in any financial recovery if the case succeeds or a settlement is reached. Whistleblowers can obtain 15% to 30% of the settlement amount, depending on the value of the information and whether the government intervenes in the case. Kickback schemes, like the one LiveCare Inc. is accused of operating, are one of the most frequent types of fraud reported under the False Claims Act.
During FY 2024, settlements and judgments under the False Claims Act exceeded $2.9 billion and over $2.4 billion of the recoveries stemmed from qui tam whistleblower lawsuits. Furthermore, according to the government, a record 979 qui tam lawsuits were filed in FY 2024.
However, in September 2024, a district judge in Florida ruled that the False Claims Act’s qui tam provisions were unconstitutional. In response, the federal government is urging the U.S. Court of Appeals for the Eleventh Circuit to reverse that decision, stating in a brief that “other than the district court here, every court to have addressed the constitutionality of the False Claims Act’s qui tam provisions has upheld them.”
National Whistleblower Center has issued an Action Alert allowing whistleblower supporters to write the members of Congress urging them to protect and strengthen and protect the False Claims Act.
Join NWC in Taking Action:
Strengthen the False Claims Act and Protect it From Attack
Further Reading:
LiveCare Inc. Agrees To Pay Up To $4.9 Million To Resolve False Claims Act Allegations