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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."
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Last Update on September 30, 2014 07:20 GMT
HONG KONG DEMOCRACY PROTESTS
HONG KONG (AP) -- Pro-democracy protesters in Hong Kong say they'll initiate new civil disobedience efforts tomorrow unless their demands for genuine democracy and the resignation of the city's unpopular chief executive are met.
The protesters spent another night blocking streets in an already unprecedented show of civil disobedience.
Even larger crowds are expected to flood the streets tomorrow, China's National Day holiday. The government says a holiday fireworks display is canceled.
Chief Executive Leung (lee-ung) Chun-ying urged the Occupy Central group today to take into account the considerations of other residents and stop its disruptive protest. And he says China's communist leaders in Beijing will not back down from an August decision to restrict voting reforms for the first direct elections to pick his successor in 2017.
The crowd, mostly students, continues to occupy a six-lane highway next to the local government headquarters.
BEIJING (AP) -- A survey has found China's manufacturing activity in September held steady at the previous month's low level, indicating the world's second-largest economy faces risks to growth.
HSBC Corp. said Tuesday its monthly purchasing managers' index stood at 50.2 on a 100-point scale on which numbers above 50 indicate expansion. It was unchanged from August's 3-month low.
A measure of export orders rose to its highest level since March 2010.
China's economy grew by 7.5 percent over a year earlier in the quarter ending in June but manufacturing, housing sales and other indicators suggest growth might be weakening.
HSBC economist Hongbin Qu said in a statement, "We think risks to growth are still on the downside and warrant more accommodative monetary as well as fiscal policies."
DRUG COMPANIES-DOC PAYMENTS
WASHINGTON (AP) -- The Obama administration is planning to release data Tuesday on drug and medical device company payments to tens of thousands of individual doctors.
The goal is to shine a light on potential ethical conflicts in medicine. Consumer groups say it's overdue, but doctors' groups fear consumers will jump to the wrong conclusions.
President Barack Obama's health care law calls for companies to report payments of $10 or more to physicians. It's a provision that has bipartisan support.
The goal is to allow patients to look up their own doctors online. That functionality won't be ready yet. But the preliminary data being released Tuesday is expected to be useful for researchers.
ATLANTIC CITY, N.J. (AP) -- A bankruptcy court auction for Revel, the failed luxury casino-hotel on the Atlantic City Boardwalk, is scheduled to resume today.
The auction that began last Wednesday was suspended due to the approach of the Rosh Hashanah holiday. Revel has refused to reveal details of what has transpired so far.
The former casino's management has received multiple bids for the property. The lone bid made public thus far is $90 million from Florida developer Glenn Straub, who envisions a gathering place for "geniuses" tackling a number of problems, with or without a casino.
The casino cost $2.4 billion to build, and had been open for just over two years before going out of business on Sept. 2.
NEW YORK (AP) -- Two supermarket companies -- Supervalu and Albertsons -- are reporting that the credit and debit card data of their shoppers may be at risk because of a hack.
The companies say that in late August or early September, malicious software was installed on networks that process card transactions at some of their stores.
Albertsons says the malware may have captured data including account numbers, card expiration dates and the names of cardholders at stores in more than a dozen states. Supervalu says the malware was installed on a network that processes card transactions at several chains, but it believes data was only taken from certain checkout lanes at four Cub Foods stores in Minnesota.
The breach could affect Albertsons stores in California, Idaho, Montana, Nevada, North Dakota, Oregon, Utah, Washington and Wyoming; Acme Markets stores in Delaware, Maryland, New Jersey and Pennsylvania; Jewel-Osco stores in Illinois, Indiana and Iowa; and Shaw's and Star Markets stores in Maine, Massachusetts, New Hampshire, Rhode Island and Vermont. The Boise, Idaho-based company has a total of 1,081 stores.
DETROIT (AP) -- Toyota says it is recalling 690,000 Tacoma pickup trucks because the rear leaf springs could break, puncture the gas tank and cause a fire.
The recall covers Tacoma Four-by-Four and Pre-Runner pickups from the 2005 through 2011 model years.
The automaker says the leaf springs can fracture due to stress and corrosion. They can move out of position and come into contact with surrounding components, including the gas tank. Toyota says it's not aware of any fires, crashes or injuries from the problem.
Owners will be notified by mail and Toyota says dealers will fix the problem at no cost.
Owners with questions can call Toyota at (800) 331-4331.
WASHINGTON (AP) -- A report by federal investigators says IRS workers are often not doing all the research they are supposed to do to track down people with unpaid tax bills.
The study doesn't estimate how much money that costs the government. But it says that in 2012, the IRS declared $6.7 billion in unpaid taxes to be uncollectable because it couldn't find the taxpayer.
The Treasury Inspector General for Tax Administration released the report Monday. That office is the agency that audits the IRS.
The report found that in 57 percent of 250 cases studied, there was no evidence that workers did all required research before declaring taxes uncollectable.
The IRS contested some of the study's findings. It said investigators had significantly overestimated the value of some of the unpaid taxes.
WASHINGTON (AP) -- Americans boosted spending by a healthy amount in August, offering welcome evidence that the economy is on solid footing heading into the final quarter of the year.
The Commerce Department reports that consumer spending in August rose 0.5 percent from the previous month after showing no gain in July. It was the best result since spending also expanded 0.5 percent in June.
Helped by higher wages and salaries, income rose a modest 0.3 percent in August, slightly faster than a 0.2 percent July increase.
The acceleration in spending added to signs that the economy is sustaining strength in the current July-September quarter. Consumer spending accounts for about 70 percent of economic activity, and the lackluster showing in July had raised concerns about whether the economy would retain the momentum it built in the spring after a harsh winter.
NEW YORK (AP) -- A New York judge has ruled that Argentina was in contempt of court on Monday for its open defiance of his orders. U.S. District Judge Thomas Griesa had issued an order requiring that U.S. hedge funds holding Argentine bonds be paid the roughly $1.5 billion they are owed if the majority of the South American nation's bondholders are paid interest on their bonds.
Griesa made the announcement after a lawyer for U.S. hedge funds -- led by billionaire hedge fund investor Paul Singer's NML Capital Ltd. -- argued that Argentina has openly defied Griesa's court orders for more than a year. The judge reserved a decision on sanctions pending further proceedings.
The judge said repeated efforts to avoid paying U.S. bondholders was illegal conduct and no longer could be ignored. Griesa said that Argentina in various ways has sought "to not attend to" its financial obligations.
DEARBORN, Mich. (AP) -- Ford shares have tumbled after the automaker said that it will fall short of its full-year profit goals.
At a conference for investors, the Dearborn, Michigan-based automaker said it expects a pretax profit of around $6 billion this year, down from the $7 billion to $8 billion it previously forecast.
Chief Financial Officer Bob Shanks said record profits in North America aren't enough to offset trouble in South America, where Ford expects to lose $1 billion this year, and Russia, where falling sales and the rapid deterioration of the ruble took the company by surprise. Warranty costs -- including a $500 million charge for last week's recall of 850,000 vehicles for defective air bags -- are also higher than expected.
Shanks said Ford expects a pretax profit of $8.5 billion to $9.5 billion in 2015, based partly upon an expected recovery in South America and improvement in warranty costs. The company also plans fewer vehicle introductions in 2015, which will cut costs. Ford is introducing 23 vehicles worldwide this year; next year, it plans to introduce 16.
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