Dr. Eric Troyer, of Landis, North Carolina, and his medical practice, Troyer Medical Inc. P.C. (TMI), have agreed to pay $429,254 to the United States to resolve alleged False Claims Act violations arising from their involvement in laboratory kickback schemes. Troyer and TMI will pay an additional $195,746 to the State of North Carolina, which jointly funded claims paid by the North Carolina Medicaid program. Troyer and his practice have agreed to cooperate with the Justice Department’s investigations of other participants in the alleged schemes.
“Kickbacks to healthcare providers can undermine the integrity of taxpayer-funded healthcare programs and medical decision making,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “We will continue to pursue those who pay or receive illegal financial inducements, including unlawful inducements for laboratory testing.”
The Anti-Kickback Statute prohibits offering, paying, soliciting or receiving remuneration to induce referrals of items or services covered by Medicare, Medicaid, TRICARE and other federally funded healthcare programs. The Anti-Kickback Statute is intended to ensure that medical providers’ judgments are not compromised by improper financial incentives and are instead based on the best interests of their patients.
The settlement announced today resolves allegations that, from August 2015 to November 2021, Troyer and his medical practice received kickbacks from a laboratory in Anderson, South Carolina, in return for Troyer’s referrals to that laboratory. According to the settlement, the kickbacks to Troyer and his medical practice allegedly were disguised as payments for purported phlebotomy services, rental of office space and the lease of a chemistry analyzer machine and resulted in the submission of false or fraudulent laboratory testing claims to Medicare, Medicaid and TRICARE in violation of the False Claims Act.
“Patients should be able trust that their healthcare provider’s recommendations are for their well-being and not for the provider’s financial gain,” said U.S. Attorney Adair Ford Boroughs for the District of South Carolina. “We will continue to hold accountable those who undermine the integrity of the healthcare system by giving or receiving kickbacks.”
“This resolution demonstrates the FBI’s dedication to addressing violations that undermine the public’s trust in our healthcare systems,” said Special Agent in Charge Steve Jensen of the FBI Columbia Field Office. “The FBI, along with our law enforcement and regulatory partners, remains committed to ensuring healthcare professionals provide transparent and ethical standards of service.”
“Kickback arrangements aimed at improperly influencing medical decisions will remain a top investigative priority for our agency,” said Special Agent in Charge Tamala E. Miles of the Department of Health and Human Services Office of Inspector General (HHS-OIG). “Our ongoing enforcement efforts in this area are focused on protecting the integrity of taxpayer-funded healthcare programs like Medicare and Medicaid, and preventing schemes that could improperly manipulate the healthcare decisions of patients and their doctors.”
“Improper financial relationships between physicians and laboratories undermine patient healthcare and trust,” said Special Agent in Charge Christopher Dillard of Department of Defense Office of Inspector General, Defense Criminal Investigative Service (DCIS) Mid-Atlantic Field Office. “Kickbacks should never be a consideration in a medical practice selecting a company for laboratory testing. DCIS will continue to bring to justice medical providers who illegally enrich themselves at the expense of the American taxpayer and wellbeing of our Warfighters.”
The settlement was the result of a coordinated effort between the Civil Division’s Commercial Litigation Branch, Fraud Section, and the U.S. Attorney’s Office for the District of South Carolina, with assistance from HHS-OIG, DCIS, FBI and the Medicaid Investigations Division of the North Carolina Attorney General’s Office.
Senior Trial Counsel Christopher Terranova of the Civil Division’s Commercial Litigation Branch, Fraud Section, and Assistant U.S. Attorney Beth C. Warren for the District of South Carolina handled the case. The United States previously resolved allegations that other physicians in South Carolina, North Carolina and Texas received kickbacks from the same laboratory.
The government’s pursuit of this matter illustrates the government’s emphasis on combating health care fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse and mismanagement can be reported to HHS at 1-800-HHS-TIPS (800-447-8477).
The claims resolved by the settlement are allegations only. There has been no determination of liability.
This crime news article "North Carolina Physician and Medical Practice Agree to Pay $625,000 to Settle Kickback Allegations" was originally found on https://www.justice.gov/usao/pressreleases