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Physician Self-Referral

Physician self-referral is when a doctor sends patients to medical services or facilities in which they or their family have a financial interest, potentially putting their own profit ahead of the patient's best care.

California Physician Self-Referral Attorneys

At Matern Law Group, we are committed to protecting the rights of employees and consumers, including the right to report illegal or unethical activity without fear of retaliation or intimidation.

What is Physician Self-Referral?

Physician self-referral happens when a doctor refers patients to medical services or facilities where the doctor or their family members have a financial stake, which could lead to conflicts of interest and not necessarily serve the best interest of the patient. This practice can raise healthcare costs and compromise the quality of care.

Legal options for consumers and employees affected by such practices include:

  1. Reporting the Issue: Patients or healthcare employees who suspect unethical self-referrals can report these concerns to state medical boards or federal agencies, like the Department of Health and Human Services (HHS).

  2. Filing a Complaint: Individuals can file a formal complaint with regulatory bodies that oversee healthcare practices. This can initiate an investigation into the physician’s referral practices.

  3. Whistleblower Lawsuits: Under laws like the False Claims Act, employees (and sometimes patients) can file a lawsuit against providers who are defrauding the government through illegal self-referrals, especially in cases involving Medicare or Medicaid. Whistleblowers may be eligible for a portion of any recovered funds if the lawsuit is successful.

  4. Seeking Legal Advice: Consulting with a lawyer who specializes in healthcare law or whistleblower cases can provide guidance on the best course of action, whether it’s pursuing legal action or finding another way to address the issue.

These steps offer ways for consumers and employees to challenge unethical practices and promote transparency and integrity in healthcare.

Filing a Physician Self-Referral Lawsuit

To start, you’ll need to identify a case where a doctor might be making referrals for personal financial gain rather than the patient’s best interest. Gathering evidence is crucial, so collect any documents, bills, or records that show the doctor’s referrals to businesses they’re connected to financially.

Consulting with a lawyer who specializes in healthcare law is your next step. They can help you understand the complexities of the law, evaluate your evidence, and decide if you have a strong case. Your lawyer will then help you prepare and file a lawsuit, outlining the illegal referrals and how they violate the Stark Law.

The process may involve the government investigating your claims if the lawsuit is filed under the False Claims Act, which is a common approach for these types of cases. If the government decides to intervene and your lawsuit leads to a recovery of funds, you might be eligible for a portion of the recovered amount. It’s important to remember that whistleblower protections apply here, too, shielding you from retaliation for filing the lawsuit. This is a complex area of law, so professional legal advice is essential every step of the way.

Our Approach

Our Practices are Guided by Integrity. We’ll protect what you deserve.

We work tirelessly and fight tenaciously to hold rights abusers accountable.

If you’ve experienced a distressing incident related to an issue like this, call us for a free case evaluation.

Did You Know?

Those who investigate and provide testimony and assistance in a False Claims Act case also are protected.
California whistleblower protection laws prohibit employers from retaliating against workers who come forward to report suspected violations of laws, regulations, and public policy.

Is It Illegal, or Just Unfair?

Legal cases can be lengthy, complicated, and confusing, but you don’t have to take on the system all by yourself. If you believe someone has violated your individual rights, or the rights of a large group of people in your community, we can help you find the right course of action.

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