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."
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Last Update on November 26, 2014 08:35 GMT
ECONOMY-THE DAY AHEAD
WASHINGTON (AP) -- The list of economic reports expected this morning is longer than usual with everything shutdown for Thanksgiving tomorrow.
The Commerce Department releases October figures on durable goods orders, personal income and spending as well as new home sales. The National Association of Realtors will release its pending home sales index for October, while Freddie Mac issues its weekly report on mortgage rates.
The Labor Department's weekly look at jobless claims also comes a day early.
From the corporate world, Deere & Co. reports its quarterly financial results before the market opens.
WASHINGTON (AP) -- The Obama administration will propose tightening the amount of a smog-forming pollutant in the air.
People familiar with the proposal tell the Associated Press that the EPA will recommend lowering the limit for ground-level ozone to 65 to 70 parts per billion, down from a 75 parts per billion standard set in the 2008.
The proposal will be announced today to meet a court-ordered Dec. 1 deadline.
The stricter standard makes good a campaign promise Obama made during his first run for the White House: to reverse President George W. Bush's decision to set a limit weaker than scientists advised.
In 2011, facing re-election, Obama scrapped an EPA plan to tighten the standard after Republicans and industries said it would hamper the economy.
SAN FRANCISCO (AP) -- Venerable tech giant Hewlett-Packard has been struggling for three years to turn its business around. Its latest earnings show it still has more work ahead.
While CEO Meg Whitman has decided to split the company in two, she has said it will take a year to disengage the sluggish printer-and-PC division from faster-growing units that sell commercial tech hardware, software and services. Meanwhile, HP reported Tuesday that its sales fell 2 percent in the most recent three-month period, marking its 12th revenue decline in the last 13 quarters.
And there was little comfort in a new forecast issued Tuesday by market research firm IDC. It predicts the global PC market will shrink 2.7 percent this year, instead of the 3.7 percent drop forecast earlier.
NEW YORK (AP) -- Twitter is expanding its reach into commerce with a new tool called "Offers."
Advertisers can post promotions and discounts in users' Twitter feeds, whether or not Twitter users follow those merchants.
To redeem an offer, customers enter their credit or debit card information. They can use the same card to redeem the promotion in a store. It only works in the U.S. but may be available in other countries in the future.
San Francisco-based Twitter says it will encrypt and store the credit card information but users can remove it any time
The short messaging service has slowly been branching out into shopping. It launched a "Buy" button in September that lets users make purchases or donate money to charities without leaving Twitter.
THANKSGIVING AT WORK
COLUMBUS, Ohio (AP) -- A lawmaker in Ohio wants retailers in the state to pay triple wages for employees who work on Thanksgiving -- an effort that comes as Macy's is allowing its workers to choose whether to work that day.
Both are attempts to counter frustration among workers and their families over holiday store hours that have expanded into the holiday.
State Rep. Mike Foley says his bill would allow employees to bow out of the holiday shift without sanctions. It comes after a federal complaint said Wal-Mart illegally fired workers protesting holiday working conditions last year.
Macy's, Wal-Mart and two dozen other major retailers open on Thanksgiving Day say consumers demand it. A spokesman says working the holiday is optional for Macy's employees this year. Those who work will be paid time-and-a-half.
WASHINGTON (AP) -- HSBC will pay $12.5 million to settle regulators' charges that its private-banking business based in Switzerland violated U.S. securities laws.
The Securities and Exchange Commission said Tuesday that the private-banking unit failed to register with the SEC before providing brokerage services and investment advice to U.S. clients. The SEC says HSBC Private Bank began doing so more than 10 years ago and collected fees totaling about $5.7 million.
A representative for HSBC, Europe's largest bank by market value, could not be reached for comment.
According to the SEC, HSBC Private Bank decided to exit the U.S. cross-border business in 2010.
DES MOINES, Iowa (AP) -- The egg is on a roll. It has never been more popular as a fast-food restaurant breakfast staple and its appeal has broadened far beyond the day's first meal.
High demand has kept egg prices at record levels, even as production soars.
The U.S. Department of Agriculture says Iowa, the nation's leading egg supplier, produced a record 1.4 billion eggs in October, up 4 percent from a year ago. Egg prices have broken records for the past 10 days, with the Midwest price reaching $2.18 a dozen on Monday.
Restaurants have broadened their menu offerings including eggs, with quick-service restaurants adding more egg-white sandwiches and eggs showing up as toppings on pizza and hamburgers.
People also use more eggs around the holidays as families cook and bake at home.
COAL LEASE LAWSUIT
BILLINGS, Mont. (AP) -- Conservation groups are suing the government to force federal officials to undertake the first broad environmental review of the government's coal-leasing program in decades.
Friends of the Earth and the Western Organization of Resource Councils filed the lawsuit Tuesday in U.S. District Court in Washington, D.C.
It's being paid for by the philanthropic foundation of Microsoft founder Paul Allen.
Supporters of the lawsuit said there hasn't been a comprehensive review of the government's coal program since 1979. That's before climate-changing gases produced by burning coal emerged as a significant public concern.
The U.S. Bureau of Land Management has been reviewing its coal-leasing program since a government investigation last year revealed officials accepted below-market bids in some coal sales.
BLM spokesman Jeff Krauss declined to comment on Tuesday's lawsuit.
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