A provider of mobile positron emission tomography (PET) scans headquartered in La Habra, California, has agreed to pay $8,334,350.71, plus additional amounts tied to future revenues, to resolve allegations under the False Claims Act (FCA) that it paid referring cardiologists excessive fees to supervise PET scans in violation of the Anti-Kickback Statute (AKS), according to a May 1, 2026, press release from the US Department of Justice.
The government alleged that from Sept. 1, 2016, through Jan. 14, 2025, the provider knowingly submitted false or fraudulent claims to federal healthcare programs stemming from AKS violations. Specifically, it allegedly paid kickbacks to referring cardiologists in the form of above–fair market value fees, ostensibly for supervising PET scans for patients they referred.
According to the allegations, these fees substantially exceeded fair market value because the provider compensated cardiologists for time spent treating other patients in their offices, for time when they were not on site, or for additional services that were rarely or never provided. The provider purportedly relied on an attorney opinion letter regarding fair market value, which the government alleged was based on fundamental inaccuracies and was later withdrawn by the consultant.
As part of the settlement, the provider entered into a five-year Corporate Integrity Agreement (CIA) with the US Department of Health and Human Services Office of Inspector General (HHS-OIG). The agreement requires the provider to implement measures to ensure that arrangements with referring physicians comply with the AKS. It also mandates a compliance program to identify and address AKS risks in other financial arrangements and requires the retention of an Independent Compliance Expert to evaluate the program’s effectiveness.
“We will diligently pursue and hold accountable healthcare providers that seek patient referrals through illegal kickbacks and other unlawful financial inducements,” said Assistant Attorney General Brett A. Shumate, head of the Justice Department’s Civil Division. “By rooting out financial relationships between healthcare providers and referring physicians that corrupt the medical decision-making process, we will continue to protect and safeguard taxpayer dollars.”
Compliance Perspective
Issue
Healthcare organizations must ensure that compensation arrangements with physicians and other referral sources are consistent with fair market value, commercially reasonable, and not tied—directly or indirectly—to the volume or value of referrals. Financial relationships that do not meet these standards may implicate the federal Anti-Kickback Statute and, when claims are submitted to federal healthcare programs, may also create liability under the False Claims Act. Payments for services that are not actually rendered, not adequately documented, or that exceed fair market value may increase regulatory risk and expose organizations to enforcement actions, financial penalties, and reputational harm.
Discussion Points
- Review and update policies and procedures governing physician arrangements, compensation structures, and supervision requirements to ensure they address fair market value, commercial reasonableness, and documentation expectations. Policies should clearly define permissible services, require verification that services are actually rendered, and establish oversight mechanisms for arrangements involving referring providers or compensation tied to services billed to federal healthcare programs. Organizations may benefit from periodic independent or consultant-supported reviews of these policies and related practices to identify gaps and align with current regulatory expectations.
- Provide ongoing education to appropriate staff on the False Claims Act, Anti-Kickback Statute, fair market value principles, and documentation requirements for services billed to federal healthcare programs. Training should emphasize that compensation must reflect services actually performed and must not be influenced by referral volume or other improper considerations, as such practices may create liability under applicable federal laws. Staff should also be trained to recognize red flags—such as payments for services not rendered or inconsistent supervision practices—and understand internal reporting procedures for potential compliance concerns. Med-Net Academy offers Fraud Series Module 9 – Independent Contracts and Referrals, which teaches staff how to follow company contracting policies, understand referral requirements, and recognize key elements of the Anti-Kickback Statute.
- Conduct routine audits of physician arrangements, time records, and supporting documentation to confirm that services billed were performed as described and that compensation aligns with fair market value. Audits should also assess whether supervision and other contractual obligations are being met in practice. Organizations may consider engaging external or consultant-led reviews, including targeted or mock audits, to provide an objective assessment, identify compliance risks early, and support timely corrective action. Contact Med-Net Healthcare Consulting or info@mednetconcepts.com for more information.
*This news alert has been prepared by Med-Net Concepts, Inc. for informational purposes only and is not intended to provide legal advice.*