Archive

September 13, 2017

MediSys Health Network Inc., which owns and operates the two Queens hospitals Jamaica Hospital Medical Center and Flushing Hospital and Medical Center agreed to pay $4 million to settle allegations that it violated the False Claims Act by engaging in improper financial relationships with referring physicians. These relationships took the form of compensation and office lease arrangements that did not comply with the requirements of the Stark Law, which restricts the financial relationships that hospitals may have with doctors who refer patients to them. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Dr. Satish Deshpande. Dr. Deshpande will receive a whistleblower award of $600,000 from the proceeds of the government's recovery. DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Hospital Fraud, Whistleblower Case, Whistleblower Rewards,

September 1, 2017

New Mexico-based Christus St. Vincent Regional Medical Center and its partner Texas-based Christus Health agreed to pay $12.24 million to resolve allegations they violated the False Claims Act by making illegal donations to county governments which were used to fund the state share of Medicaid payments to the hospital. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by a former Los Alamos County, New Mexico Indigent Healthcare Administrator. The whistleblower will receive an award of $2.25 million from the proceeds of the government's recovery. DOJ

Tagged in: FCA Federal, Hospital Fraud, Medicaid, Whistleblower Case, Whistleblower Rewards,

August 23, 2017

St. Agnes Healthcare agreed to pay roughly $123,000 to settle charges of violating the False Claims Act by billing Medicare for evaluation and management services at a higher reimbursement rate than the Federal health care programs allowed. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Jonathan Safren, a former St. Agnes cardiologist. He will receive a whistleblower award of $20,000 from the proceeds of the government's recovery. DOJ (DMD)

Tagged in: FCA Federal, Hospital Fraud, Whistleblower Case, Whistleblower Rewards,

June 30, 2017

Charlotte-Mecklenburg Hospital Authority (dba Carolinas Healthcare System) agreed to pay $6.5 million to resolve charges it violated the False Claims Act by “upcoding” claims for urine drug tests in order to receive higher payment than allowed for the tests. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Mark McGuire, a former laboratory director for CHS. He will receive a whistleblower award of roughly $1.4 million from the proceeds of the government's recovery. DOJ (WDNC)

Tagged in: FCA Federal, Healthcare Fraud, Hospital Fraud, Upcoding, Whistleblower Case, Whistleblower Rewards,

June 28, 2017

PAMC Ltd. and Pacific Alliance Medical Center Inc., which together own and operate Pacific Alliance Medical Center, an acute care hospital located in Los Angeles, agreed to pay $42 million to settle charges they violated the False Claims Act and the Stark Law by engaging in improper financial relationships with referring physicians. These relationships took the form of (1) arrangements under which the defendants allegedly paid above-market rates to rent office space in physicians’ offices, and (2) marketing arrangements that allegedly provided undue benefit to physicians’ practices. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Paul Chan, who was employed as a manager by one of the defendants. He will receive a whistleblower award of more than $9.2 million from the proceeds of the government's recovery. DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Hospital Fraud, Whistleblower Case, Whistleblower Rewards,

April 27, 2017

Indiana University Health Inc. (IU Health) and HealthNet Inc. agreed to pay a total of $18 million to resolve allegations they violated the False Claims Act by engaging in an illegal kickback scheme related to the referral of HealthNet’s OB/GYN patients to IU Health’s Methodist Hospital. According to the government, IU Health provided HealthNet with an interest-free line of credit, the balance of which consistently exceeded $10 million. The government further charged that HealthNet was not expected to repay a substantial portion of this loan and that this financial arrangement was intended to induce HealthNet to refer its OB/GYN patients to IU Health’s Methodist Hospital. DOJ

Tagged in: Anti-Kickback and Stark, Healthcare Fraud, Hospital Fraud,

April 24, 2017

Crittenton Hospital Medical Center and the Crittenton Cancer Center, together with their current owners Ascension Michigan and Ascension Health agreed to pay roughly $790,000 to resolve allegations they violated the False Claims Act by billing for medically unnecessary laboratory testing for patients who had been referred to Crittenton by Dr. Farid Fata and physicians in his office. In an earlier unrelated criminal matter, Fata pleaded guilty to health care fraud, conspiracy to pay and receive kickbacks, and promotional money laundering, and was sentenced to a term of 45 years in prison. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by an office administrator in Fata’s medical practice, Michigan Hematology-Oncology P.C. The whistleblower will receive a whistleblower award from the proceeds of the government's recovery. DOJ (EDMI)

Tagged in: FCA Federal, Healthcare Fraud, Hospital Fraud, Lack of Medical Necessity, Whistleblower Case, Whistleblower Rewards,

April 11, 2017

Norman Regional Hospital Authority (d/b/a Norman Regional Health System) and certain employees and physicians of Norman Regional agreed to pay roughly $1.6 million to settle charges of violating the False Claims Act by submitting false claims to Medicare for radiological services performed without the proper supervision by a physician. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Norman Regional radiologist Dr. Lance Garber. He will receive a yet-to-be-identified whistleblower award from the proceeds of the government's recovery. DOJ (WDOK)

Tagged in: FCA Federal, Hospital Fraud, Improper Medical Personnel, Whistleblower Case, Whistleblower Rewards,

December 7, 2016

Not-for-profit regional hospital South Miami Hospital agreed to pay approximately $12 million to settle allegations that it violated the False Claims Act by submitting false claims to federal healthcare programs for medically unnecessary electrophysiology studies and other procedures allegedly performed by Dr. John R. Dylewski. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by South Miami Hospital doctors James A. Burks and James D. Davenport. They will receive a whistleblower award of roughly $2,748,500 from the proceeds of the government's recovery. DOJ (SDFL)

Tagged in: FCA Federal, Hospital Fraud, Lack of Medical Necessity, Whistleblower Case, Whistleblower Rewards,

October 31, 2016

Tariq Mahmood, former owner and operator of several rural hospitals across Texas, was ordered to pay roughly $1.2 million for violating the False Claims Act following his conviction for committing health care fraud and for aggravated identity theft. DOJ (EDTX)

Tagged in: FCA Federal, Healthcare Fraud, Hospital Fraud,

Contact

Click here for a confidential contact or call: