Christ Hosptial Settles Fraud Claim, May Lose Medicare and Medicaid
The Health Alliance of Greater Cincinnati and the Christ Hospital Settle Claims for Violating Anti-Kickback Statute and Defrauding Medicare and Medicaid. Now, HHS is considering cutting Christ Hospital from Medicare and Medicaid reimbursement. "Health care providers should make medical decisions based on the needs of their patients, not on the financial interests of physicians or other providers," said Tony West, Assistant Attorney General for the Civil Division of the Department of Justice. "We will not allow hospitals to put profits ahead of sound medical decision-making."
The Health Alliance of Greater Cincinnati and the Christ Hospital Settle Claims for Violating Anti-Kickback Statute and Defrauding Medicare and Medicaid.
Now, HHS is considering cutting Christ Hospital from Medicare and Medicaid reimbursement.
The Health Alliance of Greater Cincinnati and The Christ Hospital agreed to pay the United States $108 million to settle claims that they violated the Anti-Kickback Statute and the False Claims Act by paying unlawful remuneration to doctors in exchange for referring cardiac patients to The Christ Hospital in a pay-to-play scheme.
The United States had alleged that The Christ Hospital developed “a scheme that provided cardiologists improper financial incentives in exchange for generating revenue for the hospital.” Specifically, Christ:
(a) Limited the opportunity to work at the Heart Station – an outpatient cardiology testing unit that provides non-invasive heart procedures – to those cardiologists who referred cardiac business to The Christ Hospital;
(b) Rewarded cardiologists whose referrals contributed at least two percent of the hospital’s yearly gross revenues with additional time at the Heart Station;
(c) Submitted claims to Medicare and Medicaid received from this illegal kickback scheme , which constituted a violation of the False Claims Act.
“Health care providers should make medical decisions based on the needs of their patients, not on the financial interests of physicians or other providers,” said Tony West, Assistant Attorney General for the Civil Division of the Department of Justice. “We will not allow hospitals to put profits ahead of sound medical decision-making.”
However, The Christ Hospital declined to enter into a Corporate Integrity Agreement acceptable to the OIG; therefore, the OIG did not provide a release of its administrative exclusion authorities and is further evaluating the matter. Christ officials called the agreement “costly, burdensome and unnecessary.”
The U.S. Department of Health and Human Services now will consider cutting Christ Hospital off from Medicaid and Medicare reimbursement, which would effectively close the hospital.
Read more: Christ Hospital could lose Medicare, Medicaid reimbursement - Business Courier of Cincinnati
http://cincinnati.bizjournals.com/cincinnati/stories/2010/05/24/daily58.html
