A medical partnership and its leadership are writing a nearly $9 million check to the federal government, settling claims of foul play in their referral practices. National Interventional Radiology Partners PLLC (NIRP), its founder Dr. Andrew Gomes, and the firm's CEO have agreed to pay $8,884,091 to resolve allegations under the Federal False Claims Act (FCA) and Anti-Kickback Statute, as announced by U.S. Attorney Alamdar S. Hamdani.
The settlement follows accusations that NIRP and Gomes, a 48-year-old resident of Sugar Land, were engaged to illegally pay physicians for patient referrals. The referrals were for clinics that provided surgical treatment for Peripheral Arterial Disease (PAD), a condition commonly found in the elderly and characterized by plaque build-up in arteries, primarily affecting the lower legs. Since 2015, Gomes has been actively establishing these clinics across Texas, with the idea to quickly treat PAD and generate a high volume of Medicare referrals.
According to the U.S. Department of Justice, Gomes raised capital from physicians who could provide patient referrals, enticing them with high returns on investments tied to the number of patients referred. These investor physicians were promised more patient referrals would result in more surgeries and, subsequently, higher profits for the participating medical professionals in the form of monthly dividends.
Hamdani condemned the arrangement, stating, "Healthcare providers that pursue patient referrals through improper financial arrangements will be held accountable." He added, “These types of improper financial arrangements corrupt medical decision making, increase costs and undermine the integrity of federally funded health programs. Patients deserve care based upon their specific medical needs and not on an individual physician’s financial interest or gain.” These sentiments were echoed by Special Agent in Charge Jason E. Meadows of the DHHS-OIG, who asserted, "Medical providers and others who unlawfully accept kickbacks for patient referrals undermine the integrity of medical decision-making and waste taxpayer dollars," as per U.S. Department of Justice.
The settlement also comes with praise for the whistleblower role in uncovering the alleged kickback scheme. FBI Houston Special Agent in Charge Douglas Williams said, “We applaud the qui tam whistleblower who exposed this scheme and encourage others to report illegal medical practices. FBI Houston will continue to identify and investigate those who would undermine the integrity of our healthcare system for their own financial gain.” The whistleblower, whose complaint in late 2018 sparked the investigation, will receive 19 percent of the recovery - a sum of $1,687,977, as mentioned by U.S. Department of Justice.
The multifaceted investigation that led to this resolution includes efforts by the Southern District of Texas's U.S. Attorney's Office, the DHHS-OIG, and the FBI, with former Assistant U.S. Attorneys Andrew Bobb and Julie Redlinger managing the case.
