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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 16, 2014 17:29 GMT
WASHINGTON (AP) -- U.S. factories continue to boost production.
The Federal Reserve says factory output rose 0.5 percent in March after a revised 1.4 percent surge in February. Manufacturing output has climbed a solid 2.8 percent over the past 12 months. Manufacturers produced more furniture, clothing, chemicals and aerospace products.
Higher factory output is a sign of greater demand by businesses and consumers. The gains over the past two months point to a rebound after a winter slowdown in January and December stalled growth across the economy.
Overall industrial production, which includes manufacturing, mining and utilities, rose 0.7 percent in March. In February, industrial production had expanded 1.2 percent.
WASHINGTON (AP) -- Home builders are picking up the pace after a frigid winter slowed work.
The Commerce Department says builders broke ground on 946,000 homes at a seasonally adjusted annual rate in March. That's a 2.8 percent increase from February and the highest level in three months.
Construction of single-family homes rose 6 percent, more than offsetting a 3.1 percent drop in the construction of apartments, condominiums and town houses.
At the same time, however, applications for building permits slid, clouding the outlook for future construction.
As the weather moderated, construction rose more than 30 percent in the Northeast and 65 percent in the Midwest. But it fell in the South and West.
Applications for building permits, a gauge of future activity, fell 2.4 percent to a seasonally adjusted annual rate of 990,000.
EARNS-BANK OF AMERICA
CHARLOTTE, N.C. (AP) -- Bank of America says it swung to a loss in the first quarter, hurt by $6 billion in legal expenses.
The Charlotte, N.C., bank reports a loss applicable to common shareholders of $514 million. That's compares with earnings of $1.11 billion a year earlier.
The loss amounts to 5 cents a share. A year earlier, the bank earned 10 cents a share.
Revenue totaled $22.66 billion after stripping out an accounting change. That was down 3.8 percent from last year.
The $6 billion legal expense stems from a previously announced settlement with the Federal Housing Finance Agency, and additional reserves for other mortgage-related matters.
The bank also says it reached a settlement with the Financial Guaranty Insurance Company, as well as separate settlements with The Bank of New York Mellon, over residential mortgage-backed securities.
OMAHA, Neb. (AP) -- CSX railroad expects to deliver modest profit growth this year, but the impact of the severe winter will linger into the second quarter.
Officials with the railroad said on a conference call today that the improving economy and stronger domestic utility demand for coal will boost CSX's earnings in the second half of this year and in 2015.
The Jacksonville, Fla.-based railroad had said Tuesday that the harsh winter disrupted shipments and contributed to a 14 percent drop in its first-quarter profit even as it hauled 3 percent more freight. CSX estimates the snow and cold cost it 8 to 9 cents per share in lost revenue and increased expenses.
MOSCOW (AP) -- Russia's economy minister says growth slowed to 0.8 percent in the first quarter due to uncertainty over the crisis in Ukraine.
Alexei Ulyukayev told parliament today that the country's economic situation has worsened because of "the acute international situation of the past two months," as well as "serious capital flight." More capital left the country in the first three months of 2014 than in all of 2013.
The growth figure fell far short of the ministry's earlier prediction of 2.5 percent.
Russian markets have been rattled by tensions between Moscow and neighboring Ukraine, where Russia annexed the Black Sea region of Crimea in March. Ukraine has accused Russia of supporting armed militants in the country's east, where pro-Russian activists have seized government buildings and police stations.
TOKYO (AP) -- The Mt. Gox bitcoin exchange in Tokyo is headed for liquidation after a court rejected its bankruptcy protection application.
Mt. Gox says the Tokyo District Court decided the company would not be able to resurrect itself under a business rehabilitation process filed for in February.
An administrator will try to sell the company's assets, and many creditors, including those who had bitcoins with the exchange, are unlikely to get any money back.
After Mt. Gox went offline in February, its CEO (Mark Karpeles) said 850,000 bitcoins worth several hundred million dollars were unaccounted for, blaming a weakness in the exchange's systems. Mt. Gox later changed the estimate for the lost virtual currency to 650,000, although the exact amount is still under investigation.
Bitcoins were created in 2009 as a way to make transactions across borders without third parties such as banks.
DETROIT (AP) -- Pressure is building for Michigan lawmakers to commit $350 million to Detroit pensions after the bankrupt city reached tentative agreements with pension funds and a retiree group.
The deals are tied to Detroit getting money from the state over 20 years, along with $466 million in private money, all to shore up pensions.
Retired police and firefighters would see smaller cost-of-living payments. Other city retirees would see a 4.5 percent pension cut. The $816 million vanishes if retirees don't vote in favor in the weeks ahead.
Republican House Speaker Jase Bolger says the deals are important, but he tells The Associated Press that persuading lawmakers to approve the money soon is difficult because of anti-Detroit sentiment in the Legislature.
Republicans control the House and Senate.
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