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 January 28, 2015 13:05 GMT
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A newly formed entity called SpinCo will inherit ownership of Yahoo's 384 million Alibaba shares when the tax-free spin-off is completed toward the end of this year.
Tuesday's much-anticipated announcement about the management of Yahoo's 15 percent stake in Alibaba overshadowed Yahoo's results for the final three months of last year.
Yahoo's shareholders are far more interested in Mayer's plans for the Alibaba stake because it's currently worth about $39 billion. That's far more than the value of Yahoo's own online services, which have been struggling to generate more revenue for the past six years.
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The report Wednesday by China's industrial regulator said Alibaba allowed unlicensed merchants to use its sales platforms and failed to protect consumers' rights adequately.
The report was the result of a meeting in July but said it was withheld to avoid affecting progress toward Alibaba's stock market listing in New York. The company went public in September after raising a record $25 billion in an initial public stock offering.
An Alibaba spokesman said the company was preparing a public statement about the report.
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WASHINGTON (AP) -- A new poll says most Americans would want Congress to restore federal subsidies for millions buying health care coverage under President Barack Obama's health care law if the Supreme Court invalidates some of that aid.
A poll by the nonpartisan Kaiser Family Foundation says more than 6 in 10 would want Congress to restore the assistance.
That could mean Republicans would face a complex political landscape if the Supreme Court annuls part of Obama's health care law this year. Republicans want to repeal and replace that law.
The court is expected to rule in June whether the law allows federal subsidies only to people buying coverage from state-run marketplaces, and not from Washington's HealthCare.gov.
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The companies say the deal has been cleared by the Federal Trade Commission and should close within five business days.
Albertsons, which is privately held and part-owned by Cerberus Capital Management, agreed to buy Safeway in March for $7.64 billion in cash. The FTC said the sale would hurt consumers in 130 markets by reducing competition, and in December the companies said they would sell 168 stores in eight states.
Most of the stores will be bought by Haggen, a chain based in the Northwest. Haggen will expand to 164 locations from 18.
Excluding the stores that are being sold, Safeway had about 1,300 locations under names including Safeway, Tom Thumb and Carrs. Albertsons had about 1,100 stores under its own name as well as Acme, Jewel-Osco, and others. The companies have about 250,000 employees combined.
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NEW YORK (AP) -- Experts say New York City's businesses lost about $200 million following the fizzled snowstorm and decision to shut down the transit system. City officials argued it was better to err on the side of caution.
Moody's Analytics economist Adam Kamins says consumers who would have otherwise made other major purchases on Tuesday will likely do so a day or two later. And he notes that many employees forced to stay home were able to telecommute.
Experts say the biggest impact would be on small businesses and hourly workers such as taxi drivers and restaurant workers. The city's 24,000 restaurants could lose millions.
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The voter-approved constitutional amendment requires Colorado to pay back taxpayers when the state collects more than the limit in a formula based on inflation and population growth.
But lawmakers don't want to put pot taxes back into people's pockets.
Republicans usually want tax dollars returned to taxpayers, but they say marijuana should pay for itself, and general taxes shouldn't pay for things like increased drug education.
Lawmakers might ask voters to exempt pot taxes from the refund requirement. Otherwise, Colorado would have to refund more than $30 million of the $50 million in recreational pot taxes it has collected.
Lawmakers would decide if the money would go to all taxpayers or just people who bought pot.
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MasterCard Inc. last week became the first major U.S. credit card company to say it would start handling U.S. card transactions in Cuba. Visa Inc. did not immediately respond to a request for comment on Tuesday.
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