UPMC Hamot and cardiology practice Medicor Associates, both in Erie, Pa., have finalized an agreement to pay the federal government $20.7 million to settle allegations they knowingly submitted claims to Medicare and Medicaid in violation of the Anti-Kickback Statute and Stark Law, according to the Department of Justice.
The lawsuit was originally brought under the qui tam, or whistle-blower, provisions of the False Claims Act by Tullio Emanuele, MD, in 2010 — one year before the hospital, then called Hamot Medical Center, was acquired by Pittsburgh-based UPMC. Dr. Emanuele worked for Medicor from 2001 to 2005.
The lawsuit alleged the hospital paid Medicor up to $2 million per year from 1999 to 2010 under services arrangements that were created to secure patient referrals from Medicor. The hospital allegedly did not have a need for the services covered by the contracts, and in some cases the services were either duplicative or not performed, according to the DOJ.
In November, the Stone Law Firm, which represented Dr. Emanuele, commented on the alleged kickback arrangement to the Pittsburgh Post-Gazette. "This is an example of the sweetheart deals between hospitals and physicians that undermine patient confidence and drive up healthcare costs for everybody," said Andrew Stone, principal of Stone Law Firm.
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