Agnesian HealthCare’s headquarters is just an hour’s drive north of Milwaukee in Fond du Lac. The company and its affiliated physician group recently agreed to pay $10 million to the state of Wisconsin and the federal government to settle a whistleblower lawsuit.
An orthopedic surgeon accused the hospital of illegally paying kickbacks to doctors in exchange for referrals of Medicare and Medicaid patients.
Federal law prohibits healthcare companies from compensating doctors for steering patients in government-funded programs to their facilities. Agnesian denied engaging in the practice, but the three-hospital system nevertheless agreed to the $10 million settlement.
The orthopedic surgeon filed his lawsuit about five years ago in Milwaukee’s federal district court. He held various leadership positions in Fond du Lac and repeatedly raised concerns about the company’s compensation system. In a released statement, he said he “chose to pursue this lawsuit out of concern for” his patients.
In court documents, the doctor said Agnesian’s compensation practice violated the federal False Claims Act, the Stark Law and the Anti-Kickback Statute. He said the company offered incentives to affiliated physicians who referred Medicare and Medicaid patients to Agnesian services and facilities.
Agnesian also deferred some compensation for referrals in order to limit the ability of doctors to refer patients to competitors if they ever left Agnesian. The healthcare system also rewarded high-referral doctors with extra compensation.
The False Claims Act and Wisconsin law protect and reward whistleblowers who file lawsuits against companies cheating Medicare, Medicaid and other government programs. The plaintiff in a whistleblower case will typically receive up to 30 percent.
If you know of a person or company defrauding the federal government, contact the Milwaukee law offices of Alan C. Olson and Associates to discuss a whistleblower lawsuit.