SSM Health hospital hit with physician kickback allegations: 4 things to know

Fond du Lac, Wis.-based Agnesian HealthCare, a part of St. Louis-based SSM Health, faces a federal lawsuit alleging the nonprofit hospital defrauded Medicare, according to the FDL Reporter.

Here are four things to know about the lawsuit, which was filed in the U.S. District Eastern Court of Wisconsin about five years ago.

1. The lawsuit, filed by a former employee with Agnesian Health's Fond du Lac Regional Clinic, alleges the system violated Stark Law by compensating physicians who funneled business to Agnesian Health.

2. Orthopedic physician Clark Searle, MD, said from 1996 through 2015, Agnesian adjusted physicians' compensation to account for specialty referrals to Agnesian facilities, services and providers. He also claimed deferred payments were linked to an agreement limiting which providers physicians could refer patients to if those physicians left Agnesian. There were exceptions to this agreement, such as if a referral to a non-Agnesian facility was in the patient's best interest, Dr. Searle said.

3. Agnesian Health told FDL Reporter it denies the claims. The system referenced Republic Gov. Scott Walker's repeal of the Wisconsin False Claims for Medical Assistance Law in 2015, which is Wisconsin's version of Stark Law.

4. Proceedings in the lawsuit are scheduled through mid-2019. Dr. Searle requested a jury trial and triple the amount of damages, according to the report.

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