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Healthcare Practice to Pay $4.75M for Kickback, Unnecessary Testing Allegations

Atlanta Gastroenterology Associates located in Atlanta, Georgia, has agreed to pay $4.75 million to resolve allegations that it violated the False Claims Act by receiving kickbacks in exchange for referrals of gastrointestinal pathology services and by performing certain gastrointestinal pathology services that were not medically reasonable or necessary. The United States alleged that beginning in approximately May 2017, Atlanta Gastroenterology Associates contracted with Advanced Pathology Solutions (APS), a pathology laboratory located in Little Rock, Arkansas, to construct and operate a limited-capacity pathology laboratory in Atlanta Gastroenterology Associates’ office.

Atlanta Gastroenterology Associates received various benefits from APS in connection with the setup and ongoing operations of the in-house lab, in which histology technicians prepared and stained specimen sample slides and Atlanta Gastroenterology Associates billed Medicare and other insurers for the technical component of those services. In exchange, Atlanta Gastroenterology Associates agreed to exclusively refer patients to APS, which interpreted the slides and billed for the professional component of the services. The United States alleges that the benefits provided by APS to Atlanta Gastroenterology Associates were unlawful remuneration in exchange for patient referrals.