NIRP and founder to pay nearly $9M to resolve alleged kickback referral violations

HOUSTON - National Interventional Radiology Partners PLLC (NIRP) along with its founder and its CEO have agreed to pay to the United States $8,884,091 to resolve Federal False Claims Act (FCA) and Anti-Kickback Statute violation allegations, announced U.S. Attorney Alamdar S. Hamdani.

The settlement claims NIRP and Dr. Andrew Gomes, 48, Sugar Land, illegally paid physicians for referrals to clinics established to surgically treat patients with Peripheral Arterial Disease (PAD), a circulatory disease which causes plaque build-up in the arteries. It most commonly affects the lower legs of elderly individuals.

Beginning in 2015, Gomes established a number of clinics throughout Texas under the NIRP umbrella to surgically treat PAD. Gomes raised capital for these clinics from physicians who had medical practices that would provide a strong patient base for Medicare referrals including primary care physicians, doctors of podiatric medicine and family practitioners.

Gomes' pitch to the investor physicians was that they could ensure high returns on their investment in each surgical center from referring significant numbers of patients for treatment. Gomes told the investing physicians that more patient referrals would lead to more revascularization surgeries and higher profits - which funnels back to the investing physicians as monthly dividends.

Gomes also told the physicians that once the surgical centers were up, running and profitable, they could be sold which would create additional value for investors. Surgeries such as arteriograms, angiograms, angioplasties and atherectomies that revascularize the lower limbs of patients with PAD are highly compensated procedures.

"Healthcare providers that pursue patient referrals through improper financial arrangements will be held accountable," said Hamdani. "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."

"Medical providers and others who unlawfully accept kickbacks for patient referrals undermine the integrity of medical decision-making and waste taxpayer dollars," said Special Agent in Charge Jason E. Meadows of Department of Health and Human Services-Office of Inspector General (DHHS-OIG). "We remain committed to working with our law enforcement partners and prosecutors to hold those who defraud Medicare accountable and restore the integrity of the Medicare trust fund."

"Dr. Gomes and NIRP clearly prioritized greed above the health and well-being of their elderly patients," said FBI Houston Special Agent in Charge Douglas Williams. "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."

This civil settlement resolves claims brought under the qui tam or whistleblower provisions of the FCA. Under those provisions, a private party can file an action on behalf of the United States and receive a portion of the recovery. In this instance, the whistleblower filed his complaint in late 2018, which triggered this investigation. The whistleblower will receive 19 percent of the recovery or $1,687,977. The FCA is one of the most powerful tools that the federal government has in its arsenal combat health care fraud.

The investigation and resolution of the allegations was the result of a coordinated effort between the U.S. Attorney's Office for the Southern District of Texas, DHHS-OIG and FBI.

Former Assistant U.S. Attorneys Andrew Bobb and Julie Redlinger handled the case.

The claims resolved by the settlement are allegations only and there has been no determination of liability.