Pennsylvania surgeon settles false billing allegations for $4.25M

A Pennsylvania surgeon has agreed to pay $4.25 million to resolve allegations related to kickbacks and false billing, according to the U.S. Justice Department.

The federal government said Oct. 3 that it settled with Glenn A. Kline, DO, and Community Surgical Associates to resolve the allegations, which involved kickbacks received from Lancaster (Pa.) Regional Medical Center and Heart of Lancaster (Pa.) Medical Center. Both hospitals were formerly operated by Health Management Associates, a Naples, Fla.-based company acquired by Franklin, Tenn.-based Community Health Systems in 2014.

Dr. Kline practiced as a general surgeon in Lancaster between 2009 and 2012 and was a significant source of surgical business in that area, according to the Justice Department. The federal government added that the physician had "significant leverage over HMA as it attempted to compete in the Lancaster market," because of his ability to refer patients to Lancaster Regional Medical Center and Heart of Lancaster Medical Center.

Prosecutors alleged HMA paid Dr. Kline 300 percent more than the Medical Group Management Association median salary for comparable general surgeons to secure referrals by the physician, as well as additional amounts to benefit Community Surgical Associates, his Lancaster practice.

"As alleged, Dr. Kline was paid these amounts as kickbacks for his referral of patients to Lancaster Regional Medical Center and Heart of Lancaster Medical Center, which in turn billed federal healthcare programs for those patients' services," the Justice Department said. "According to the complaint, these arrangements were intentionally structured to disguise payments which were, in actuality, payments for patient referrals, not for legitimate services."

The settlement resolves allegations initially brought in a whistleblower lawsuit.

 

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