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Agreement to Pay the Government $6 Million Highlights Coexisting Criminal and Civil Exposure in False Claims Act and Anti-Kickback Matters.

Last month, Mr. Roderic Bain, the owner of over a dozen durable medical equipment companies, was sentenced to 40 months in federal prison and ordered to pay over $1.9 million in fines for submitting over $10 million in claims to Medicare for medically unnecessary durable medical equipment, such as back and knee braces. According to the U.S. Attorney’s Office for the Southern District of Georgia, Mr. Bain participated in a network that paid kickbacks for patient information and was part of a $1 billion nationwide Medicare fraud scheme the DOJ aptly named “Operation Brace Yourself.”

After Mr. Bain’s guilty plea and sentencing, the federal government sued, alleging False Claims Act and Anti-Kickback Statute violations against Mr. Bain’s companies. The government did not name Mr. Bain individually, but alleged that between 2008 and 2018, Mr. Bain’s companies made false statements and representations related to services involving Medicare and Medicare Advantage. The parties filed a consent judgment the same day the government filed its lawsuit requiring Mr. Bain’s companies to pay the government $5,962,923.00.

Mr. Bain’s criminal case and the civil case involving his companies highlight the breadth and reach of the False Claims Act, Anti-Kickback Statute, and other federal statutes that the DOJ often utilizes in healthcare fraud matters. These cases reveal the importance of strategically managing and appreciating the criminal, civil, and administrative exposure that healthcare providers and suppliers often face in today’s regulatory environment.