United States Files False Claims Act Complaint against Community Health Network
Seattle Whistleblower Attorneys report that the United States has filed a complaint against Community Health Network Inc. (Community) in the U.S. District Court for the Southern District of Indiana, the Department of Justice announced today. Community, an integrated health care system in central Indiana, is alleged to have violated the Stark Law and thereby submitted false claims to the Medicare program.
The Stark Law prohibits a hospital 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 government’s complaint alleges that Community had employment relationships with a number of physicians that did not meet any Stark Law exception because the compensation Community paid to the physicians was well above fair market value and because Community conditioned paying bonuses on physicians achieving a minimum target of referral revenues to the hospital. The complaint alleges that Community received referrals from these physicians in violation of the Stark Law and submitted claims to Medicare knowing that the claims fr those referred services were not eligible for payment.
The United States filed its complaint in a lawsuit originally filed under the qui tam or whistleblower provisions of the False Claims Act, which allow private parties to file suit on behalf of the United States for false claims and to receive a share of any recovery. The False Claims Act permits the United States to intervene and take over the lawsuit, as it has done here in part. Those who violate the Act are subject to treble damages and applicable penalties.
The case is captioned United States and the State of Indiana ex rel. Thomas Fischer v. Community Health Network, Inc., et al. No. 1:14-cv-1215 (RLY-DKL) (S.D. Ind.).
The claims in which the United States has intervened are allegations only, and there has been no determination of liability.
Source: Dept. of Justice
The Stark Law prohibits a hospital 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 government’s complaint alleges that Community had employment relationships with a number of physicians that did not meet any Stark Law exception because the compensation Community paid to the physicians was well above fair market value and because Community conditioned paying bonuses on physicians achieving a minimum target of referral revenues to the hospital. The complaint alleges that Community received referrals from these physicians in violation of the Stark Law and submitted claims to Medicare knowing that the claims fr those referred services were not eligible for payment.
The United States filed its complaint in a lawsuit originally filed under the qui tam or whistleblower provisions of the False Claims Act, which allow private parties to file suit on behalf of the United States for false claims and to receive a share of any recovery. The False Claims Act permits the United States to intervene and take over the lawsuit, as it has done here in part. Those who violate the Act are subject to treble damages and applicable penalties.
The case is captioned United States and the State of Indiana ex rel. Thomas Fischer v. Community Health Network, Inc., et al. No. 1:14-cv-1215 (RLY-DKL) (S.D. Ind.).
The claims in which the United States has intervened are allegations only, and there has been no determination of liability.
Source: Dept. of Justice