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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 August 29, 2014 17:14 GMT
WASHINGTON (AP) -- U.S. consumer spending fell in July, with a drop in auto purchases accounting for most of the weakness. Income growth also slowed in July.
The Commerce Department says consumer spending edged down 0.1 percent last month after a 0.4 percent increase in June. It was the first decline in spending since January. Income growth slowed to a 0.2 percent rise in July, the weakest showing in seven months.
The fall in spending came primarily from a decline in auto sales, which took a breather in July after posting big gains in recent months, although spending in other areas was also weak.
Consumer spending accounts for 70 percent of economic activity, so it needs to recover for the economy to keep its momentum in the second half of the year.
WASHINGTON (AP) -- U.S. consumer sentiment ticked up in August, driven by greater optimism about jobs, rising incomes, and increasing wealth. The increase largely occurred among higher-income groups.
The University of Michigan says its index of consumer sentiment rose to 82.5 from 81.8 in July. Still, it has barely risen in the past year.
Consumers have sent mixed signals in recent months. The Michigan index has fluctuated between 80 and 82.5 since December. A measure of consumer confidence by the Conference Board rose this month to nearly a seven-year high. And yet Americans cut back their spending in July.
Nearly 60 percent of households in the top third of income earners say they are financially better off this month, the Michigan survey found, compared with only 36 percent in the bottom two-thirds.
DETROIT (AP) -- U.S. investors should soon be able to buy stock in Chrysler for the first time in seven years.
Italy's Fiat and Chrysler are merging to form Fiat Chrysler Automobiles. Fiat says Friday that an ongoing tally of investors suggests there is not enough opposition to derail the deal.
Earlier this month, Fiat shareholders approved combining the companies. But Italian law gives dissenters the right to cash out. Fiat has said that if investors offered more than 500 million euros ($650 million) in shares, the merger would be off.
Fiat SpA will announce the final tally by Sept. 4. So far the maximum number of shares to be cashed is below the cap.
Shares of Chrysler haven't been publicly traded since 2007 when it was still combined with German automaker Daimler.
RICHMOND, Va. (AP) -- Federal regulators are putting Reynolds American Inc.'s planned $25 billion takeover of rival cigarette maker Lorillard Inc. under the microscope.
The nation's second-biggest tobacco company said Friday that the Federal Trade Commission has asked for additional information as part of an antitrust review of the deal.
In July, Reynolds announced the deal to combine two of the nation's oldest and biggest tobacco companies, creating a formidable No. 2 to rival Altria Group Inc., owner of Philip Morris USA.
Reynolds markets Camel, Pall Mall and Natural American Spirit cigarettes. Lorillard sells Newport, Maverick and Kent cigarettes.
The companies plan to sell the Kool, Salem, Winston, Maverick and blu eCig brands to Imperial Tobacco Group for $7.1 billion to ease regulatory concerns about competition.
HEALTH OVERHAUL-TAX FORMS
WASHINGTON (AP) -- The federal agency that brought you the glitchy HealthCare.gov website has a massive new project.
If the Health and Human Services department has trouble this time, that could delay tax refunds for many people.
Complicated connections between the new health care law and income taxes will start to surface in 2015.
HHS has to send millions of people who got health insurance tax credits this year a new tax form that's like a W-2 for health care. It's called a 1095-A.
If they're delayed beyond Jan. 31, people who got coverage through the new insurance exchanges may have to wait to file their taxes -- and collect their refunds.
Some tax preparation companies are worried.
The Obama administration says it's on task, but won't provide much detail.
BRUSSELS (AP) -- Inflation has fallen to an annual 0.3 percent in August for the 18 countries that use the euro, underlining the shakiness of the continent's economic recovery.
Eurostat, the EU statistics agency, says the figure is down from 0.4 percent in July, as expected by market analysts.
Core inflation, which excludes volatile food and energy, sent a modestly brighter signal as it rose to 0.9 percent from 0.8 percent.
The eurozone economy showed no growth in the second quarter as fears about the Ukrainian crisis weighed on consumers and investment decisions.
The European Central Bank has warned that inflation expectations are worsening and says it will add more stimulus if needed. Many analysts are predicting the bank will launch large-scale purchases of financial assets to pump more money into the economy.
SAO PAULO (AP) -- Brazil's government says the country's gross domestic product contracted 0.6 percent in the second quarter compared with the previous three months, sending the country's economy into a recession.
The government's IBGE statistics bureau said Friday it was the second consecutive quarterly contraction of the economy.
In the first quarter of the year, GDP was reported as having grown 0.2 percent. But that figure was revised downward to minus 0.2 percent.
The IBGE says the country's GDP stands at 1.27 trillion reals ($567 billion).
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