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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."
More Business News
Last Update on September 19, 2014 17:24 GMT
NEW YORK (AP) -- Alibaba's stock is surging as the Chinese e-commerce powerhouse begins its first day trading as a public company.
The stock opened at $92.70 on the New York Stock Exchange this morning, up 36 percent from the initial $68 per share price set Thursday evening.
At that price the company would be worth $228.5 billion, more than companies such as Amazon, Ebay and even Facebook.
On Thursday, Alibaba and the investment bankers arranging the IPO settled on a price of $68 per share. The company and its early investors raised $21.8 billion in the offering, which valued Alibaba at $168 billion in one of the world's biggest ever initial public offerings.
But after a two-hour trading delay due to strong demand, it opened much higher than that price. If the stock closes at $92.70, the IPO will have raised close to $30 billion.
WASHINGTON (AP) -- A gauge designed to predict the economy's future health rose in August but at a much slower pace than in July.
The Conference Board says its index of leading indicators rose 0.2 percent in August, the seventh straight increase. But that was much slower than the revised 1.1 percent gain in July.
Conference Board economist Ken Goldstein says even with the slowdown in August, the index shows the economy is still gaining traction.
WASHINGTON (AP) -- Unemployment rates rose in nearly half of U.S. states in August, even as employers in two-thirds of the states added jobs.
The Labor Department says unemployment increased in 24 states, fell in 15 and was unchanged in 11. Hiring picked up in 35 states, while it fell in 15.
Unemployment rates can rise even when hiring increases if more people start looking for work and don't immediately find jobs. The figures suggest hiring was broad-based across most regions of the country last month, even as nationwide job gains in August were the weakest this year.
Georgia reported the nation's highest unemployment rate, at 8.1 percent, followed by Mississippi at 7.9 percent. That's the first time Georgia has had the highest rate since the Great Recession ended.
LONDON (AP) -- Businesses and investors have reacted with relief to Scotland's decision to reject independence from the United Kingdom.
The No campaign won 55 percent of the votes cast in Thursday's referendum. The 10-point victory margin was wider than expected -- most opinion polls on the eve of the vote showed a narrower 4-point victory.
British stocks responded positively to the news Friday, with the FTSE 100 index up 0.3 percent. Royal Bank of Scotland shares were up, and the bank, which is majority-owned by the U.K. government, said it was "business as usual" for its customers.
Some had warned that if Scotland left, uncertainty over the future value of the British pound and government debt would have rattled the U.K economy.
In the currency markets, the pound was solid too, rising to a two-year high against the euro.
IRVING, Texas (AP) -- Exxon Mobil says it will stop drilling an exploratory well in Russia's Kara Sea in compliance with U.S. sanctions against Russia over Russia's involvement in the Ukraine.
Exxon planned to drill the well between August and October. The latest round of sanctions called for the removal of U.S. workers on projects in the Russian Arctic by Sept. 26.
Exxon says it has received a license from the U.S. Treasury Department to wind down operations, but it is unclear whether the license will allow Exxon to stop drilling on the schedule it had already laid out. Exxon could not be immediately reached for comment.
NEW YORK (AP) -- The maker of Pabst Blue Ribbon beer is being sold to Russian company Oasis Beverages for an undisclosed sum.
In addition to its namesake beer, Pabst Brewing Co. makes Colt 45, Old Milwaukee and Schlitz. Pabst was acquired in 2010 by C. Dean Metropoulos & Co., which is known for investing in food brands.
Pabst Brewing, now based in Los Angeles, traces its roots back to 1844 in Milwaukee. Since purchasing it in 2010, Metropoulos has enlisted comedian Will Ferrell to market the company's beers. Pabst Blue Ribbon has also grown in popularity in part for its blue-collar appeal and cheap price.
Oasis is buying Pabst with TSG, an investment firm known for its work with consumer products companies. TSG Consumer Partners will take a minority stake in Pabst.
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