Abiomed: The Dinner Guests Who Made the Bill Look Smaller

In the Abiomed Impella meals settlement, the company agreed to pay $3.1 million to resolve allegations that it bought lavish physician meals to encourage use of its heart pumps, which the government said cost more than $20,000 each. The government said employees listed people who never attended, making the real cost per diner look lower. Managers allegedly approved the expenses. Someone who booked those dinners, attended them or reviewed the reimbursements could recognize the gap between the table and the expense report.

The Department of Justice announced the settlement on March 8, 2018. A former employee brought the False Claims Act case against the Danvers, Massachusetts manufacturer. The case followed a sales expense through the company’s own approval system and into allegations about physician decisions and Medicare claims.

Impella Meals and Fictitious Attendees

Abiomed allegedly used expensive meals to influence physicians choosing its Impella pumps. The government named restaurants including Menton in Boston, Nobu in Los Angeles, Spago in Beverly Hills and Eleven Madison Park in New York City.

According to the government’s announcement, some meals involved alcohol orders inconsistent with legitimate scientific discussion. The government also alleged that employees invited physicians’ spouses, who attended without a business purpose.

Abiomed had its own $150 per-person meal guideline. The government alleged that numerous meals went well above it, including one that exceeded $450 per attendee. The expense reports then supplied a way to make the spending look smaller: employees allegedly misrepresented the number of diners, used a generic entry made of a first name and a specialty or listed people who had not been there at all.

Adding a person on paper changed the apparent cost per head without changing what the restaurant charged.

The government also said Abiomed managers approved all the meal expenses it described.

What the Expense Reports Told Accounting

The whistleblower’s complaint alleged that accounting instructed him to complete attendance records without identifying everyone at the meal. Its account brings the reader inside the approval process:

The alleged instruction would leave accounting with an incomplete account of who benefited, despite the company’s written spending guideline. The government’s fictitious-attendee allegation goes further: the names themselves allegedly made the reported cost look lower.

The complaint also alleged that the whistleblower refused to approve a $1,623 reimbursement request for a meal at the Watermark Restaurant in Nashville on October 25, 2012 because it included neither a justification nor any attendees.

The complaint also quoted another employee describing a joint dinner and its approval:

The employee’s account described easy reimbursement for a large dinner bill. Alongside the alleged attendance instruction, it shows why the approval process itself became part of the complaint’s story.

The Physician Chose, the Hospital Bought

Physician choice connected the alleged hospitality to the sale. Abiomed’s annual report for the fiscal year ended March 31, 2018 described use in the cath lab and heart surgery suite, where physicians made decisions about circulatory support.

The buyer and the chooser occupied different places in that transaction. The Department of Health and Human Services’ Office of Inspector General explains physician preference in device purchasing this way: physicians may make or strongly influence the brand and type of implantable device, while the hospital or surgery center buys it. Paying for the physician’s evening therefore reaches a person with influence over somebody else’s purchasing budget.

Abiomed’s filing makes the commercial setting specific. The company said healthcare institutions generally purchased its products and relied on insurers to cover the associated patient care. It also described clinical support staff, primarily registered nurses and others with surgery-suite or cath-lab experience, who trained physicians to use its products. The manufacturer had contact with the people making treatment decisions through the work of introducing and supporting the device.

The filing also explained the payment after the purchase. Hospitals using Abiomed devices for inpatient procedures generally received Medicare payment for the hospital care through a bundled amount based on the patient’s condition and procedures. The device’s purchase and implantation costs sat inside that payment. The hospital’s bill for treatment is where the manufacturer’s sales conduct could reach Medicare.

Abiomed’s account of the settlement expressly described allegations that it caused third parties to submit false claims to Medicare. That is the full chain in this case: manufacturer-paid hospitality, a physician’s product decision, and a provider’s claim for the treatment. The expense report sits at the beginning of it.

Why Are Kickbacks Illegal?

The 2020 Journal of Forensic and Investigative Accounting article A Forensic Accountant’s Guide to the Most Potent Federal Laws Used Against Healthcare Fraud explains that the Anti-Kickback Statute covers cash or benefits in kind exchanged for purchases or recommendations covered by federal health care programs. It also explains how the False Claims Act gives whistleblowers a way to bring cases involving kickbacks. For the Abiomed allegations, that connects the restaurant spending to the treatment claim: the alleged benefit was the meal, and the alleged purpose was to influence device use.

Can a Medicare Fraud Whistleblower Receive a Reward?

A whistleblower case under the False Claims Act can pay 15% to 30% of what the government recovers. The Justice Department announced a reward for the former Abiomed employee who brought this case.

The employee brought a qui tam case on the government’s behalf. His knowledge of the company’s reimbursement process helped put the dinner expenses and the attendance records at the center of that case.

What Are Some Examples of Kickbacks in Healthcare?

Lavish meals, entertainment and payments for supposed training have all featured in medical-device kickback allegations. The recurring issue is what the manufacturer bought with the benefit: the program’s stated purpose and the activity that actually took place can tell different stories.

Biotronik’s 2022 settlement offers a close comparison. The government alleged that the company paid physicians for excessive new-employee training, including events that never occurred or offered little value to trainees. The government said Biotronik made those payments despite warnings from its compliance department that salespeople had too much influence over the selection of physician trainers. The same settlement covered alleged holiday parties, winery tours and lavish meals without a legitimate business purpose.

The training allegations give a sales or compliance employee another way into the problem. The relevant questions concerned which physicians salespeople selected, what training took place and what compliance had already said about the arrangement. At Abiomed, the comparable details were who ate, what purpose the meal served and what the company approved. In each case, the activity behind the expense description mattered.

What Evidence Is Needed to Prove Fraud?

For an Impella meal allegation, the useful evidence connects the actual dinner to its expense report, the approval, the physician’s device decisions and the resulting treatment claims. We help the insider show where their account fits in that chain and build it into a case.

The value of an insider’s account is the connection it makes between those records. An attendance list can make an expensive meal appear cheaper. The person who knows who actually sat at the table can explain why the company’s paperwork tells the wrong story.

You Know Who Was at the Table

If you saw attendee lists changed, meals approved without a business purpose or hospitality aimed at a physician’s device choices, talk to our whistleblower experts about what happened inside the company. We build the case with you, connect the sales practices to the government-paid care, and bring in medical-device kickback whistleblower lawyers. You have our expertise and advocacy from the first account of the dinner through the pursuit of a recovery.