Qui Tam 101 » United States http://false-claims-act.net Straightforward Information & Insight on Qui Tam Lawsuits Fri, 13 Aug 2010 21:22:15 +0000 http://wordpress.org/?v=2.9.2 en hourly 1 Dallas Hospital Reaches Settlement With the Government for Stark Violations http://false-claims-act.net/dallas-hospital-reaches-settlement-with-the-government-for-stark-violations-2/ http://false-claims-act.net/dallas-hospital-reaches-settlement-with-the-government-for-stark-violations-2/#comments Wed, 02 Jan 2008 15:29:55 +0000 Nolan and Auerbach http://false-claims-act.net/?p=75 According to the U.S. Attorney Richard B. Roper of the Northern District of Texas, Harris Methodist HEB Hospital, a 284 bed acute-care facility, will pay $1.9 million to settle allegations that it violated the False Claims Act by improperly submitting claims for payment for orthopedic-related items and services.  These claims were identified as having taken place between March 15, 2004 and September 1, 2005.

According to the hospital in its own news release, the parent company of Harris Methodist HEB Hospital (Texas Health Resources) did a self report by telling the Office of Inspector General of Health and Human Services about it identification of a physician contract that did not comply with federal regulations. This triggered an investigation based on information provided by Harris Methodist HEB that Medicare and Texas Medicaid programs paid for orthopedic items and services referred to the hospital by a physician group that received free rent from the hospital, a violation of Stark self-referral law (also known as Physician Self-Referral Law).

The Stark law was created to forbid physicians from profiting from their own referrals.  This law acts to sanction improper physician referrals and to stop the potential for over-utilization. In this fashion, physicians and other health care professionals are able to exercise independent judgment for what is in the best interests of their patients as opposed to themselves.

To read the full story click here or on the following to read more about the False Claims Act and the Stark Laws .

If you believe you have information concerning a violation of the False Claims Act and want to read more about Nolan & Auerbach, P.A. you may contact us.

]]> http://false-claims-act.net/dallas-hospital-reaches-settlement-with-the-government-for-stark-violations-2/feed/ 0 Inflated Cost Reports Cost California Hospital Over $2 Million to Settle False Claims Act Allegations http://false-claims-act.net/inflated-cost-reports-cost-california-hospital-over-2-million-to-settle-false-claims-act-allegations/ http://false-claims-act.net/inflated-cost-reports-cost-california-hospital-over-2-million-to-settle-false-claims-act-allegations/#comments Mon, 30 Apr 2007 14:57:28 +0000 Nolan and Auerbach http://false-claims-act.net/?p=72 On April 20, 2007, the Loma Linda Behavioral Medicine Center paid the United States government in excess of $2 million to settle allegations of overbilling from 1992-1996.  The settlementis the result of a lawsuit filed by a whistleblower under the False Claims Act.  The lawsuit was originally filed in 1998 by a former employee of Healthcare Financial Advisors (HFA), a consulting firm that assists hospitals in preparing cost reports that are submitted to insurers.  The lawsuit alleged that Healthcare Financial Advisors prepared for clients two costs reports; one which was inflated and sent to Medicare and another one designed for internal use only, that accurately reflected the amount of reimbursement the hospital should have received from Medicare.  It should be noted that seven defendants thus far have settled the HFA whistleblower lawsuit, paying approximately $55 million to the government. (Jackson Memorial Hospital in Miami, Florida more than $14 million; St. Elizabeth Regional Medical Center in Lincoln, Nebraska more than $4 million, Lovelace Health System, a wholly owned subsidiary of Cigna Corp. based in Albuquerque, New Mexico, paid $24.5 million in 2002; St. Joseph’s Hospital in Houston, Texas, paid the government $1.5 million in 2002; Eisenhower Medical Center, located in Rancho Mirage, Calif., paid $8 million in 2005 and HealthSouth Bakersfield Rehabilitation Hospital in Bakersfield, Calif., paid $740,000 in 2005).

To read more click here and here or to learn more on cost report fraud click on this link.

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