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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 May 24, 2013 17:22 GMT
DURABLE GOODS
WASHINGTON (AP) -- U.S. orders for long-lasting manufactured goods rebounded in April, buoyed by more demand for military and civilian aircraft and an increase in business investment.
The Commerce Department says durable goods orders rose 3.3 percent last month after a 5.9 decline in March.
And a measure of business investment plans increased 1.2 percent after a revised 0.9 percent gain in March. Business ordered more machinery, computers and electronics last month.
More spending by businesses could ease fears that companies are worried about slower global growth and deep cuts in U.S. federal spending.
Durable goods are items expected to last at least three years.
NEWS CORP-SPLIT
NEW YORK (AP) -- News Corp. says its board of directors has approved plans to split its entertainment and publishing businesses into two separate companies.
News Corp. also said Friday that the target date for the split is June 28. The company holding its TV and movie properties will be 21st Century Fox. The new News Corp., a smaller entity, will be focused on newspapers and publishing. Both will be publicly traded.
The board also approved a program for the publishing business to buy back $500 million of shares after the split.
News Corp.'s board had previously approved a preliminary split plan. The latest vote was on the formal proposal to split. Shareholders are expected to approve the split on June 11.
Rupert Murdoch will be chairman of both companies and CEO of Fox.
HEALTH CARE-UNIONS
WASHINGTON (AP) -- They were enthusiastic backers of President Barack Obama's health care overhaul -- but now, some labor unions are afraid that it will jeopardize benefits for millions of their members.
And they're warning that unless the problem is fixed, there could be consequences for Democrats facing re-election next year.
The problem lies in the multi-employer health plans that cover unionized workers in industries with seasonal or temporary employment -- like retail and construction. They are jointly administered by unions and smaller employers, and provide continuous coverage to more than 20 million workers and family members -- even during times of unemployment.
They were already more costly to run than traditional single-employer health plans. But the Affordable Care Act has added to that cost -- for these plans and others -- by requiring health plans to cover dependents up to age 26, eliminate coverage limits and extend coverage to people with pre-existing conditions.
An official with the Operating Engineers Union says there's a concern that employers will be tempted to drop coverage through the jointly-administered plans, and let workers "fend for themselves on the health exchanges."
The head of the United Food and Commercial Workers International Union, Joe Hansen, says the situation "makes an untruth out of what the president said -- that if you like your insurance, you could keep it."
GERMANY-ECONOMY
BERLIN (AP) -- A closely watched survey shows that German business confidence rebounded this month -- an unexpectedly strong showing that sends a hopeful signal for Europe's biggest economy.
The Ifo think tank said Friday that its confidence index rose to 105.7 points for May from 104.4 last month. The upturn followed two consecutive declines and beat economists' expectations of a very slight increase to 104.5.
The German economy returned to modest growth in the first quarter and the country's central bank said this week that it expects an improvement in the current quarter.
Earlier Friday, a separate survey showed a significant rise in German consumer confidence as people's expectations for the economy and for their own income improve.
FRANCE-EXECUTIVE PAY
PARIS (AP) -- France's finance minister says the government is no longer planning to cap executives' salaries in the private sector, amid concerns it is antagonizing the big businesses needed to reinvigorate the economy.
The Socialist government imposed limits last year on executive pay at state-run companies, and pledged to do the same in the private sector.
Pierre Moscovici confirms in an interview with business daily Les Echos, published Friday, that the government will pursue a 75-percent tax for salaries above 1 million euros ($1.3 million), to be paid by employers. But he says the government "will not go any farther than that" in its efforts to get companies to better spread their wealth among employees. "There will be no specific draft law on the governance of companies," he is quoted as saying.
SLOVENIA-FINANCIAL CRISIS
LJUBLJANA, Slovenia (AP) -- Slovenia's parliament has adopted a cap on public spending to try to convince investors that it will be able to avoid needing an international bailout.
The vote in the assembly on Friday means Slovenia's constitution will be changed to require that the government budget be balanced -- it will not be allowed to spend more than it earns in taxes. The budget should be balanced by 2015.
Slovenia is racing to convince foreign investors it has a credible strategy to reduce debt and stay solvent. In addition to a two percent hike in the retail sales tax, the government has recently pledged to privatize 15 state-run companies.
Public debt is set to surge to 71 percent of GDP in 2014 as the state faces huge costs saving its banks.
SWITZERLAND-TAX EVASION
GENEVA (AP) -- Switzerland's top negotiator in talks to resolve disputes over tax evasion with Europe and the U.S. is stepping down.
The Finance Ministry said Friday that Michael Ambuehl will leave his post at the end of August and go into academia.
The move comes at a crucial time for Switzerland, which is trying to reach a deal with the U.S. to save Swiss banks and their employees from prosecution for aiding U.S. tax cheats.
During Ambuehl's three-year tenure, Switzerland sealed tax deals with Britain and Austria. A deal with neighboring Germany was blocked by that country's Parliament.
Previously Ambuehl was Bern's top negotiator on Iran, where Switzerland represents U.S. interests.
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WASHINGTON (AP) -- U.S. orders for long-lasting manufactured goods rebounded in April, buoyed by more demand for military and civilian aircraft and an increase in business investment.
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