Healthcare FMV Advisors News & Updates

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News & Updates on FMV compliance issues brought to you by Healthcare FMV Advisors, LLC.

Ashland Hospital Corp. d/b/a King’s Daughters Medical Center (KDMC) has agreed to pay $40.9 million to resolve allegations that it submitted false claims to the Medicare and Kentucky Medicaid programs for medically unnecessary coronary stents and diagnostic catheterizations and had prohibited financial relationships with physicians referring patients to the hospital, the Justice Department announced today.Assistant Attorney General Stuart F. Delery of the Justice Department’s Civil Division, U.S. Attorney Kerry Harvey for the Eastern District of Kentucky and Special Agent in Charge Derrick L. Jackson at the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) Kentucky region made the announcement.“Hospitals that place their financial interests above the well-being of their patients will be held accountable,” said Assistant Attorney General Delery. “ The Department of Justice will not tolerate those who abuse federal health care programs and put the beneficiaries of these programs...

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Medtronic Inc., of Fridley, Minnesota, has agreed to pay the United States $9.9 million to resolve allegations under the False Claims Act that the company used various types of payments to induce physicians to implant pacemakers and defibrillators manufactured and sold by Medtronic, the Justice Department announced today. “Improper financial incentives have the potential to compromise physician medical judgment,” said Assistant Attorney General Stuart F. Delery of the Justice Department’s Civil Division. “This case demonstrates the Department of Justice’s commitment to pursue medical device manufacturers that use improper financial relationships to influence physician decision-making.”The United States alleged that Medtronic caused false claims to be submitted to Medicare and Medicaid by using multiple types of illegal kickbacks to induce physicians to implant Medtronic pacemakers and defibrillators. Specifically, Medtronic allegedly induced physicians to use its products by: 1) paying implanting physicians...

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OIG alleged that Harper's Hospice paid remuneration to a physician in the form of medical directorship fees. Specifically, the OIG contends that Harper's Hospice paid the remuneration to the physician in exchange for the physician referring patients to Harper's Hospice for hospice services and pre-singing blank prescription forms for patients treated by Harper's Hospice.

OIG alleged that UVMC paid improper remuneration to physicians who invested in a joint venture ambulatory surgical center with UVMC.

Somerset Medical Center – a regional medical center located in Somerville, N.J. – has paid $435,640 to settle allegations that it violated the federal False Claims Act by making improper rental payments to a cardiology group that referred large numbers of patients to the hospital, New Jersey U.S. Attorney Paul J. Fishman announced today.The civil settlement agreement is between the United States of America – acting through the U.S. Attorney’s Office for the District of New Jersey and on behalf of the Office of Inspector General of the U.S. Department of Health and Human Services (HHS-OIG) – and Somerset Medical Center.“Making inflated rental payments to induce referrals is no better than slipping a doctor an envelope stuffed with cash,” U.S. Attorney Fishman said. “Kickback arrangements undermine the physician-patient relationship and can lead to unnecessary treatment and higher costs. There is no room in our healthcare system for hospitals that abuse federal health care programs to boost their bottom line.”“Today’s...

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A radiologist who owned and operated a diagnostic testing center in Orange, N.J., was sentenced today to 46 months in prison and ordered to forfeit more than $2 million for overseeing a sprawling cash-for-patients scheme to bribe doctors for testing referrals, U.S. Attorney Paul J. Fishman announced. Ashokkumar Babaria, 64, of Moorestown, N.J., previously pleaded guilty before U.S. District Judge Claire C. Cecchi to an information charging him with one count of offering and paying doctors and other health care providers illegal cash kickbacks for patient referrals in violation of the federal health care anti-kickback statute. Judge Cecchi imposed the sentence today in Newark federal court.According to documents filed in this case and statements made in court:Babaria, then a licensed radiologist, was the medical director and owner of Orange Community MRI LLC (Orange MRI). The facility provided diagnostic testing services, such as MRIs, CAT Scans, ultrasounds, echocardiograms and dual-emission X-ray absorptiometries,...

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Amedisys Inc. and its affiliates (Amedisys) have agreed to pay $150 million to the federal government to resolve allegations that they violated the False Claims Act by submitting false home healthcare billings to the Medicare program, the Department of Justice announced today. Amedisys, a Louisiana-based for-profit company, is one of the nation’s largest providers of home health services and operates in 37 states, the District of Columbia and Puerto Rico. Additionally, this settlement resolves certain allegations that Amedisys maintained improper financial relationships with referring physicians. The Anti-Kickback Statute and the Stark Statute restrict the financial relationships that home healthcare providers may have with doctors who refer patients to them. The United States alleged that Amedisys’ financial relationship with a private oncology practice in Georgia – whereby Amedisys employees provided patient care coordination services to the oncology practice at below-market prices – violated statutory...

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United States Attorney William J. Ihlenfeld, II, announced that Devender Batra, M.D., and Belmont Cardiology, Inc. will pay $1 million to the United States after causing East Ohio Regional Hospital and Ohio Valley Medical Center to submit fraudulent claims to Medicare from January 2009 to August of 2010, in violation of the Federal False Claims Act. The settlement ends an investigation into improper compensation arrangements between Dr. Batra, East Ohio Regional Hospital and Ohio Valley Medical Center. The arrangements with Dr. Batra and Belmont Cardiology led the hospitals to submit false claims for prohibited referrals for various health services in violation of Federal law.AThese types of prohibited referrals are a significant problem and lead to increased health care costs for everyone,” said U.S. Attorney Ihlenfeld. “Medicare expects that a physician’s referral of a patient to a hospital will be free from improper influences, and when it’s not we will act to hold the wrongdoers accountable.”The investigation...

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PITTSBURGH - West Penn Allegheny Health System, Inc. (“WPAHS”) has agreed to pay the United States $1,529,281.50 to settle False Claims Act allegations, United States Attorney David Hickton announced today.The settlement results from a self-disclosure by WPAHS to the United States Attorney’s Office. Based on information provided by WPAHS, the United States alleged that WPAHS leased space to physicians at below-market rates to induce referrals of patients to WPAHS, in violation of the Anti-Kickback Statute and Stark Law. The United States further alleged that these referrals resulted in improper claims being submitted to federal health care programs.The Anti-Kickback Statute prohibits offering, paying, soliciting, or receiving remuneration to induce referrals of items or services covered by Medicare, Medicaid, and other federally funded programs. The Stark Law forbids a hospital from billing federally funded programs for certain services referred by physicians who have a financial relationship with the hospital,...

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