U.S. District Judge Roy B. Dalton Jr. Tosses Whistleblower’s Kickback Suit Against Health First

Law360 – A Florida federal judge on Friday tossed a whistleblower’s suit against Health First Inc., ruling the whistleblower is still missing some crucial facts about the allegedly fraudulent kickback scheme at the nonprofit health system.

U.S. District Judge Roy B. Dalton Jr. said that while relator Omni Healthcare Inc. does not have to prove its claims yet, the court “cannot be left wondering whether a plaintiff has offered mere conjecture or a specifically pleaded allegation on an essential element of the lawsuit.”

Omni says Health First illegally ties its doctors’ compensation to how many referrals they make within its system.

But Judge Dalton said he needs more specifics, like which doctors were overpaid for their referrals or how the Medicare patients presented in a list to the court were referred to Health First.

“Relator failed to allege with particularity how Health First and [Health First Medical Group] compensated doctors based on referrals, who was part of this fraudulent scheme (as opposed to all HFMG doctors), when oncologists received bonuses based on drug administration, and which Medicare claims were tainted because of improper referrals or kickbacks for drug administration — and as an outsider, the basis for these allegations,” Judge Dalton said.

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