Jan
27
Written by:
admin
1/27/2012 2:04 PM
This settlement resolves a qui tam lawsuit filed by Daniel S. Jorgenson, M.D., a plastic surgeon who formerly practiced in Ithaca. The lawsuit was filed on behalf of the United States of America and the State of New York. Dr. Jorgenson alleged in his complaint that Cayuga Medical Center recruited physicians into the local area pursuant to recruitment agreements which violated federal law, known as the Stark Law; the Medical Center submitted claims for payment to Medicare and Medicaid, while certifying that it was in compliance with federal law, when in fact it was not; and violated the False Claims Act, 31 U.S.C. § 3729 et seq.
The Stark Law (42 U.S.C. §1395nn) applies to recruitment agreements between hospitals and physicians. This law prohibits a physician from referring patients to a hospital if the physician has a financial relationship with the hospital, unless an exception applies. The Stark law also prohibits a hospital from billing Medicare for a prohibited referral. Federal regulations and - 2 -
related guidelines allow for hospitals to pay for certain expenses of medical practices who employ physicians recruited to the area by the hospital. Dr. Jorgenson alleged that Cayuga Medical Center paid for expenses that were not permitted by regulations and guidelines and improperly extended a recruitment agreement and therefore submitted false claims to Medicare and Medicaid when it certified in connection with billing that it was complying with federal laws and regulations.
The lawsuit also alleged a violation of the New York State False Claims Act.
Cayuga Medical Center voluntarily disclosed to the U.S. Department of Health and Human Services, Office of Inspector General additional recruitment agreements which did not
comply with the Stark Law, and cooperated with this investigation. The investigation found no evidence of any criminal violations, either by Cayuga Medical Center or any other entity. The investigation found no evidence that patient care or safety was compromised in any way.
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