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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 April 17, 2014 17:08 GMT
WASHINGTON (AP) -- The number of people applying for U.S. unemployment benefits last week rose 2,000 to a seasonally adjusted 304,000. Jobless claims continue to be near pre-recession levels despite the slight increase.
The Labor Department says that the four-week average of applications, a less volatile measure, fell 4,750 to 312,000. That is the lowest four-week average since October 2007, just two months before the Great Recession started. The average has fallen by 53,500 applications over the past 12 months.
Applications are a proxy for layoffs. The current level of claims suggests that employers are holding on their workers with the expectation of stronger economic growth ahead.
Employers added 192,000 jobs in March and 197,000 in February, the Labor Department reported. Hiring has picked up after a slowdown caused by severe winter weather.
WASHINGTON (AP) -- Average U.S. rates on fixed mortgages fell this week for the second straight week as the spring home-buying season begins.
Mortgage buyer Freddie Mac says the average rate for the 30-year loan fell to 4.27 percent from 4.34 percent last week. The average for the 15-year mortgage eased to 3.33 percent from 3.38 percent.
Mortgage rates have risen about a full percentage point since hitting record lows about a year ago.
Many analysts have been expecting an improving economy to lift the housing market, which has been recovering over the past two years. But housing has struggled to maintain momentum. Rising home prices and higher mortgage rates have held back some potential home buyers. Others have had trouble qualifying for mortgages.
NEW YORK (AP) -- Investment bank Goldman Sachs says its first-quarter earnings fell as fixed income trading slumped.
The bank earned $1.9 billion in the quarter, down 11 percent from the same period a year earlier when it made $2.2 billion.
The earnings were equivalent to $4.02 a share. Analysts polled by FactSet had predicted earnings of $3.49 a share.
Revenue totaled $9.3 billion, down 8 percent from a year earlier, when the bank generated revenue of $10.1 billion. The latest quarterly revenue beat analysts' expectations of $8.7 billion.
Goldman's stock rose $2.78, or 1.8 percent, to $160 in pre-market trading.
NEW YORK (AP) -- PepsiCo reports a stronger-than-expected first-quarter profit as the company slashed costs and sold more snacks around the world.
The company, which makes Frito-Lay, Gatorade, Mountain Dew and Tropicana, says global snack volume rose 2 percent while beverages were even from a year ago.
In its closely watched North American beverage unit, PepsiCo Inc. says volume was even. Growth in other drinks offset a 1 percent decline in sodas.
For the quarter, the company earned $1.22 billion, or 79 cents per share. Not including one-time items, it earned 83 cents per share, above the 75 cents per share Wall Street expected.
A year ago, it earned $1.08 billion, or 69 cents per share.
Revenue edged up to $12.62 billion, higher than the $12.39 billion analysts expected.
EL SEGUNDO, Calif. (AP) -- Toy maker Mattel says weak sales of Barbie and markdowns to clear out excess inventory left over from a sluggish holiday season led to an unexpected first-quarter loss.
Toy makers are facing a weak environment globally due to the uncertain economy and popularity of electronic gadgets.
The largest U.S. toy maker says its net loss for the three months ended March 31 totaled $11.2 million, or 3 cents per share. That compares with net income of $38.5 million, or 11 cents per share last year. Analysts expected earnings of 7 cents per share.
The company which makes Disney Princess dolls and Hot Wheels cars says revenue fell 5 percent to $946.2 million. Analysts expected $947.6 million. Barbie revenue dropped 14 percent.
NEW YORK (AP) -- Target is vastly expanding the goods that are available to order by subscription as it fends off its biggest non-traditional retail rival, Amazon.com.
The nation's second-largest discounter first dabbled with subscriptions last September, trying to win over haggard parents with 150 baby care products.
That program has been expanded more than tenfold this week to nearly 1,600 items across a much wider array of consumer goods. Everything from beauty products and pet supplies, to home office supplies like printer ink, are now available through subscription.
Target, based in Minneapolis, is playing catch up in the subscription arena, which has exploded as companies test consumer appetites for almost every niche, from socks to razors, to clothing and entertainment.
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