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HCA - Parkridge Fined $16.5 Million
HCA Inc., one of the nation’s largest private hospital chains, has agreed to pay $16.5 million to settle alleged violations of the Ethics in Patient Referrals Act (also known as the Stark law), the False Claims Act, and other federal and state laws and regulations in connection with the operation of its subsidiary, Parkridge Medical Center, Inc., in Chattanooga. In addition, Parkridge Medical Center has entered into a comprehensive five-year Corporate Integrity Agreement with the Office of Inspector General of the U.S. Department of Health and Human Services (HHS-OIG) to ensure its continued compliance with federal health care benefit program requirements.
During 2007, HCA, through its subsidiaries Parkridge and HCA Physician Services (HCAPS), entered into a series of financial transactions with a physician group, Diagnostic Associates of Chattanooga, through which it provided financial benefits intended to induce the physician members of Diagnostic to refer patients to HCA facilities. The financial benefits included lease of office space from Diagnostic at a rental rate well in excess of fair market value to meet the mortgage obligations of the Diagnostic members and release of Diagnostic members from a separate lease obligation. These financial arrangements violated the Ethics in Patient Referrals Act and the Anti-Kickback Statute – laws designed to protect patients as well as the integrity of government-funded health care benefit programs such as Medicare, Medicaid, TRICARE, and TennCare.
As U.S. Attorney Bill Killian explained, “Physicians should make decisions regarding referrals to health care facilities based on what is in the best interest of patients without being induced by payments from hospitals competing for their business.”
Federal law prohibits hospitals from submitting claims to government-funded health care benefit programs for inpatient and outpatient hospital services referred, ordered, or arranged for by physicians who have prohibited financial arrangements with those hospitals.
"We will not allow hospitals to provide financial incentives to induce physicians to steer patients their way," said Derrick L. Jackson, Special Agent in Charge, HHS-OIG in Atlanta. "These arrangements can corrupt medical decision-making and may result in unnecessary diagnostic testing and hospital admissions."
During the period from 2007 through 2011, HCA through Parkridge, submitted or caused to be submitted claims to Medicare, TRICARE, and TennCare/Medicaid for inpatient and outpatient hospital services referred, ordered or arranged for by the Diagnostic physician members who benefitted from the prohibited financial arrangements between HCA Diagnostic. Medicare and the other health care benefit programs paid the claims for those hospital services, and this settlement addresses the financial harm to the Medicare and Medicaid trust funds, TriCare and TennCare for the moneys paid out of those funds which HCA improperly claimed and received during that time period. Under the False Claims Act, a recipient of such funds may be liable for as much as three times the amount paid by the government program plus civil penalties.
The determination of the losses suffered by the government in a False Claims Act case based on violations of the Stark law depends largely upon the number of physicians who benefitted from the financial arrangements with the hospital, the number of patients referred by those physicians to the hospital, and the amount paid by the government to the hospital for claims submitted for all those patients. The False Claims Act further provides for trebling of any losses and penalties of between $5,500-$11,000 per claim.
“Today's settlement is the third since 2005 involving violations by hospitals in Chattanooga of the Ethics in Patient Referrals and False Claims Acts and reflects the Justice Department's continued determination to enforce these laws to protect both patients and the Medicare and Medicaid trust funds,” said U.S. Attorney Killian. Mr. Killian further noted that this settlement resulted from a comprehensive investigation which began as a result of a qui tam or whistleblower complaint filed in 2008. After an administrative subpoena was served on HCA subsidiaries in July 2009, HCA produced documents to the United States and made its personnel available for interviews.
"The Defense Criminal Investigative Service is committed to ensuring that TRICARE, the U.S. military health care program, continues to provide safe and superior medical care to America's Warfighters and their families." said John F. Khin, Special Agent in Charge, Defense Criminal Investigative Service- Southeast Field Office. "The successful resolution of this case demonstrates the effectiveness of joint investigations to combat health care fraud and preserve the integrity of this vital program."
Tennessee Attorney General Bob Cooper noted: "We are proud to have worked closely with our federal partners to bring this case to resolution. Combating fraud is essential to the strength and integrity of the TennCare program and is a high priority of this office."
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Last Update on July 29, 2014 17:09 GMT
WASHINGTON (AP) -- U.S. consumers are more confident about the economy than they have been in nearly seven years.
The Conference Board's confidence index rose to 90.9 in July from an upwardly revised 86.4 in June. The July reading is the highest since October 2007, two months before the Great Recession officially began.
It was the third straight increase in the index. Economists said that strong job growth has helped boost consumers' assessment of current conditions and also improved their outlook on jobs and the economy.
Conference Board economist Lynn Franco says that the improvements in consumers' confidence and expectations about the future indicate that the recent strengthening in overall economic growth should continue in the second half of the year.
WASHINGTON (AP) -- U.S. home prices rose in May from a year earlier, but at the weakest pace in 15 months.
The Standard & Poor's/Case-Shiller 20-city home price index increased 9.3 percent in May from 12 months earlier. That's down from 10.8 percent in the previous month and the smallest annual gain since February 2013.
Yearly price gains slowed in 18 of the 20 cities. They accelerated in Charlotte, N.C., and were flat in Tampa, Fla.
Existing home sales have picked up, rising to an eight-month high in June. But they are still 2.3 percent below last year's level. And an index of signed contracts dipped in June, suggesting sales will cool.
Home sales have been restrained by weak wage gains and tight credit, particularly for first time buyers.
NEW YORK (AP) -- Pfizer's second-quarter earnings plunged 79 percent from last year, when the world's second-largest drugmaker booked a business spinoff gain of more than $10 billion. The latest results still edged analyst expectations.
Pfizer says it earned $2.91 billion in the quarter. That compares with earnings of $14.1 billion last year.
Revenue slipped 2 percent to $12.77 billion, while analysts forecast $12.47 billion, on average.
Pfizer Inc. is best known for creating medicines for the masses, including the erectile dysfunction pill Viagra, the Prevnar vaccine against pneumonia and related infections and the now-generic cholesterol fighter Lipitor, which was once the world's best-selling drug.
UNDATED (AP) -- A big one-time gain and a tax benefit have helped drugmaker Merck more than double its second-quarter profit, raise the lower end of its profit forecast and easily top analysts' expectations.
The maker of popular Type 2 diabetes pill Januvia and cholesterol medicines Vytorin and Zetia says net income increased to $2 billion from $906 million in the same quarter a year earlier.
The world's fourth-biggest drugmaker reports revenue of $10.93 billion, down 1 percent from $11.01 billion a year ago.
Sales of Merck's prescription drugs totaled $9.09 billion, down 2 percent as cheaper generic competition cut into sales of some older medicines and sales of its hepatitis C drugs was hurt by new brand-name competition.
ATLANTA (AP) -- UPS is lowering its outlook for the year as it announces plans to spend more on technology and other enhancements to improve service during peak season.
UPS says it will spend $175 million on upgrades that include expanded operations on the day after Thanksgiving and sped-up deployment of software designed to help drivers find the quickest route to a destination.
During last year's holiday season, a big increase in online shopping and a crush of last-minute orders by shoppers who jumped on offers of free shipping caught UPS by surprise. The company was forced to hire extra workers to handle the rush, but some gifts still arrived late.
As a result of the boost to spending, UPS has lowered its full-year outlook for adjusted earnings to $4.90 to $5 a share. It previously expected to earn around $5.05 a share.
UPS also says second-quarter profit declined to $454 million from $1.07 billion in the same quarter a year earlier.
DETROIT (AP) -- Suzuki is recalling nearly 26,000 midsize cars in the U.S. because the daytime running light modules could overheat and cause a fire.
The recall covers the Verona from the 2004-2006 model years. It's an expansion of an earlier recall of the Forenza and Reno.
All the cars were made by General Motors in Korea. Suzuki says in documents filed today with government safety regulators that a transistor in the modules can overheat in the instrument panel. That could melt the module, which could cause a fire. Suzuki says there were no fires reported in Verona models.
Dealers will replace the modules for free. Owners will be notified later.
American Suzuki Motor Corp. filed for Chapter 11 bankruptcy protection in November of 2012 and stopped selling automobiles in the U.S.
BEIJING (AP) -- China's anti-monopoly agency says it's investigating Microsoft, stepping up regulatory pressure on foreign technology companies.
The State Administration for Industry and Commerce says it opened a case in June after complaints Microsoft improperly failed to publish all documentation for its Windows operating system and Office software. It says investigators visited Microsoft's China headquarters in Beijing and branches in three other cities this week.
Foreign technology suppliers face growing pressure from Chinese regulators, who have launched anti-monopoly investigations and announced plans to examine products for security flaws.
Microsoft has not responded to a request for comment.
ALBANY, N.Y. (AP) -- Thirteen states have settled an investigation into improper lending with a court agreement that's expected to provide $92 million in debt relief for some 17,800 U.S. military personnel.
New York Attorney General Eric Schneiderman says deceptive practices by Rome Finance Co. included failing to accurately disclose charges and interest rates and helping retailers inflate prices, with repayments take from soldiers' paychecks.
Rome Finance has recently done business as Colfax Capital Corp. and Culver Capital LLC.
The states involved are Colorado, Delaware, Florida, Georgia, Kentucky, Indiana, Iowa, Massachusetts, Michigan, New York, North Carolina, Tennessee and Vermont.
Authorities say military personnel will keep financed merchandise like computers and gaming systems with debt forgiven, including $2.2 million for more than 550 New York residents.
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