The US Department of Justice announced, on January 7, 2020, that it had filed a complaint against Community Health Network Inc. (Community) in Indiana claiming the health provider had submitted false claims to Medicare. Stark law prohibits medical providers from billing Medicare “for services referred by a physician with whom the hospital has an improper financial relationship that does not meet any statutory or regulatory exception. “
The complaint asserts that Community arranged to pay physicians for more than fair market value for the services that were rendered and because bonuses were conditioned on a minimum amount of referral revenues to the hospital. Generally, violations of Stark Law are also violations of the Federal False Claims Act if the payments are made by federal health care agencies.
The Assistant Attorney General said that these improper financial relationships between doctors and hospitals drive up Medicare costs and corrupt the decision making process. Referrals should be made based solely on the best interests of the patient. They should not be made due to any financial benefit to the doctor making the referral. Hospitals must develop compliance plans to guard against fraud and improper payments in order to participate in the Medicare program.
The lawsuit was filed through the qui tam provisions of the False Claims Act. The qui tam provision provides that a whistleblower who originates the complaint is entitled to a percentage of any recovery. The recovery includes the ill-gotten payments and also statutory fines in the amount of treble damages and any other penalties.
Any contractors, employees, doctors, or others who are aware of health care fraud, improper financial relationship, or kickbacks should contact an experienced False Claims Act Lawyer. You may be entitled to a percentage of any recovery. The California Law Offices of Stephen A. Danz and Associates are ready to help you get justice. To make an appointment, call us at online contact form to schedule an appointment. Se habla espanol.or use our