6 Recent Stark, False Claims and Kickback Lawsuits Involving Hospitals and Systems

1. Allegations of Overbilling and Kickbacks at Florida's Halifax Health Move Forward
A whistleblower case accusing Halifax Health Medical Center of Medicare fraud and kickbacks will continue after a U.S. district judge denied a motion for dismissal by the Daytona Beach, Fla.-based hospital. Halifax's director of physician services filed the lawsuit in 2009, claiming Halifax overbilled Medicare by tens of millions each year "for many years," according to the report. The lawsuit claims Halifax inappropriately admitted patients, billed Medicare for their services and allegedly had financial relationships with physicians in violation of federal anti-kickback laws.

2. 6-Year-Old Whistleblower Suit Accusing IASIS Healthcare of Kickbacks is Dismissed
A whistleblower's complaint against Franklin, Tenn.-based IASIS Healthcare, which claimed the 19-hospital system paid kickbacks in exchange for referrals, has been dismissed by a federal judge in Arizona. U.S. District Judge Robert Clive Jones rejected the complaint from Jerre Frazier, former vice president of ethics and compliance for IASIS who filed the complaint in March 2005. Mr. Frazier claimed the system performed unnecessary medical procedures and illegally paid physicians for patient referrals to pad profits. The system said the court's order in favor of IASIS "should effectively bring to an end" Mr. Frazier's qui tam litigation.

3. Former VP of Children's Hospital of Philadelphia Charged With Embezzling $1.7M
Roosevelt Hairston Jr., the former executive vice president and general counsel for Children's Hospital of Philadelphia, has been accused of embezzling $1.7 million from the facility. Mr. Hairston allegedly hid the theft by creating shell companies, opening bank accounts in their names and establishing phony offices for them. Prosecutors claim the alleged fraud occurred from 1999 until February 2011, and they say Mr. Hairston used the funds he allegedly stole to create a "luxurious" lifestyle.

4. Federal Investigation Looks for Stark, Anti-Kickback Violations at Florida's Broward Health
A federal investigation is examining physician contracts at Fort Lauderdale, Fla.-based North Broward Hospital District. Agents from the inspector general of the Department of Health and Human Services issued the district, also known as Broward Health, a subpoena May 17 to review contracts given to more than 27 physicians for violations of Stark and Anti-Kickback laws. The subpoena was issued in connection with an investigation over possible false claims to Medicare and Medicaid relating to physician reimbursements. 

5. Florida's St. Luke's Hospital Faces False Claims Allegations

A former hospital employee has filed a lawsuit accusing St. Luke's Hospital in Jacksonville, Fla., of falsely billing Medicare and Medicaid during an 11-month span. The suit claims the hospital falsely billed the government from April 2008 until March 2009. The suit says the hospital was ineligible for Medicaid and Medicare payments because its accreditation allegedly transferred when its former operator, Mayo Clinic, opened a new facility and St. Vincent HealthCare took over St. Luke's. The lawsuit claims St. Luke's continued claiming Mayo's accreditation as its own when it was under St. Vincent HealthCare's ownership. 

6. Court Dismisses Neurosurgeon's False Claims Suit Against New York's Upstate University Hospital
A neurosurgeon's lawsuit against Upstate University Hospital in Syracuse, N.Y., claiming the hospital retaliated against him after he spoke out of improper care, has been dismissed on jurisdictional grounds by a federal judge. James Holsapple, MD, filed the suit accusing Upstate, a state hospital, of violating the federal False Claims Act through alleged Medicare and Medicaid fraud. He also claimed the hospital violated state labor law by retaliating him after he complained by cutting his pay and demoting him. U.S. District Court Judge Thomas McAvoy granted the hospital's motion to dismiss the complaint because under the False Claims Act, claims against the state are barred by the 11th Amendment.

Related Articles on Healthcare Fraud:
10 Recent Stark, False Claims and Kickback Lawsuits Involving Hospitals and Health Systems
5 Recent Settlements by Healthcare Providers
12 Fraud and False Claims Cases Involving Physicians

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars