CVS Subsidiary Oak Street Health Agrees to $60M Settlement in Medicare Kickback Violations
CVS Subsidiary Oak Street Health Agrees to $60M Settlement in Medicare Kickback Violations
The allegations center around Oak Street Health's Client Awareness Program, launched in 2020, which aimed to increase membership through third-party insurance agents.Wednesday, Oak Street Health, a subsidiary of CVS Health Inc (NYSE:CVS), agreed to settle for $60 million following allegations that it violated the False Claims Act.
周三，西维斯健康旗下的子公司橡树街健康公司（NYSE:CVS）同意支付6000万美元，以了结违反虚假索赔法的指控。
The claims involved paying kickbacks to third-party insurance agents to recruit seniors to its primary care clinics, a practice that led to false Medicare submissions.
这些指控涉及向第三方保险代理支付回扣，以招募老年人前往其初级保健诊所，这种做法导致虚假的医保申请。
Also Read: Pharmacy Chains Like CVS Health, Walgreens Boots Alliance Confront Shifting Consumer Habits And Profit Pressures.
另请阅读：像西维斯健康、沃尔格林-联合博姿这样的药店连锁面临消费习惯和利润压力的转变。
The allegations center around Oak Street Health's Client Awareness Program, launched in 2020, which aimed to increase membership through third-party insurance agents.
这些指控围绕着橡树街健康公司于2020年推出的客户意识计划展开，该计划旨在通过第三方保险代理增加会员数量。
These agents targeted seniors enrolled or eligible for Medicare Advantage (MA) plans, directing them toward Oak Street's services.
这些代理针对参加或有资格参加Medicare Advantage（MA）计划的老年人，引导他们使用橡树街的服务。
In exchange, agents received approximately $200 per referral, incentivizing them to prioritize financial gain over seniors' best interests.
作为交换，代理每次推荐可获得约200美元的报酬，这激励他们优先考虑财务利益而不是老年人的最佳利益。
This behavior violated the Anti-Kickback Statute, which prohibits offering payment to induce patient referrals under federally funded programs like Medicare.
这种行为违反了禁止向联邦资助计划（如Medicare）下的患者推荐提供报酬的《反回扣法》。
The U.S. Department of Justice (DOJ) claimed that Oak Street Health knowingly submitted false claims to Medicare between September 2020 and December 2022 due to these illegal kickbacks.
美国司法部（DOJ）声称，橡树街健康公司知情地在2020年9月至2022年12月间向Medicare提交了虚假索赔，原因是这些非法的回扣。
"Health care providers that attempt to profit from kickbacks will be held accountable," said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department's Civil Division. "We are committed to rooting out illegal practices committed by Medicare Advantage providers, insurance agents and brokers that undermine the interests of federal health care programs and the patients they serve."
“试图从回扣中获利的医疗保健提供者将受到追责，”正义部民事部副助理部长布赖恩·M·博因顿表示。 “我们致力于查处医疗保险优势提供者、保险代理人和经纪人所犯下的违法行为，这些行为损害了联邦医疗保健计划和服务于患者的利益。”
Additionally, the settlement resolves claims brought under the whistleblower provisions of the False Claims Act by Joseph Stinson. Stinson will receive $9.9 million as part of the settlement.
此外，此次和解还解决了根据《虚假索赔法》的内部告密者规定提出的索赔。斯廷森将在和解过程中获得990万美元。
Last week, Walgreens Boots Alliance Inc. (NASDAQ:WBA) agreed to pay $106.8 million to settle allegations that it submitted false claims to government healthcare programs, violating the False Claims Act and state regulations.
上周，沃尔格林-联合博姿股份有限公司（NASDAQ：WBA）同意支付10680万美元，以解决其向政府医疗保健计划提交虚假索赔、违反虚假索赔法和州法规的指控。
Price Action: CVS stock is up 0.27% at $58.58 at the last check Thursday.
价格走势：CVS股票在最后一次检查时涨0.27%，至58.58美元。
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