Reliance Medical Systems LLC, a distributor of spinal implant devices headquartered in Bountiful, Utah, its owners, Bret Berry and Adam Pike, and two of their physician-owned distributorships have agreed to pay $1 million to resolve a lawsuit against them alleging that they violated the False Claims Act by paying physicians to use Reliance medical devices in spinal surgeries on their own patients.
The Justice Department’s lawsuit alleged that the defendants operated physician-owned distributorships (PODs) that, in reality, were vehicles for the payment of kickbacks to induce physicians to use Reliance’s medical devices in their surgeries. The Anti-Kickback Statute prohibits offering or paying anything of value to encourage the referral of items or services covered by federal health care programs.
The Justice Department contends that the defendants’ PODs paid physicians based on their referrals, made false statements to health care providers, and terminated physicians who did not refer enough patients. The complaint alleged that Berry and Pike were recorded attempting to induce a spine surgeon to join Kronos Spinal Technologies, one of Reliance’s PODs, by offering to pay him a share of the profits he generated for Kronos after he proved his “loyalty” to Kronos.
“As today’s settlement demonstrates, we will look to the substance, not just the form, of an arrangement to determine whether the payment of remuneration constitutes an illegal kickback,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “The department is committed to redressing the corrupting influence of kickbacks on federal health care programs, regardless of how companies seek to characterize such payments.”
“When health care companies try to boost their profits through kickbacks arrangements, they compromise the integrity of medical decision-making while increasing health care costs for everyone,” said Special Agent in Charge Timothy B. DeFrancesca of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG). “Working with our law enforcement partners, our agency is committed to thoroughly investigating such schemes.”
The United States filed this lawsuit in 2014, and this settlement was reached after the first day of trial. The case is captioned United States of America v. Reliance Medical Systems, LLC, et al., No. 14-6979 (C.D. Cal.).
This settlement is the most recent in a series of settlements with persons affiliated with Reliance Medical Systems. The Civil Division previously recovered over $9.25 million from owners of Reliance PODs.
The investigation and resolution of this matter illustrate 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 the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).
This matter was handled by the Civil Division’s Commercial Litigation Branch (Fraud Section) Attorneys Robert Chandler and David Finkelstein, with assistance from HHS-OIG.
The claims asserted against defendants are allegations only and there has been no determination of liability.