by Ben Vernia | May 20th, 2017
On May 18, the Department of Justice announced that two hospitals, located in Southwest Missouri, had agreed to pay $34 million to settle civil allegations, originally brought by a whistleblower, that they submitted claims for chemotherapy services tainted by improper compensation to referring oncologists. According to DOJ’s press release:
Two Southwest Missouri health care providers have agreed to pay the United States $34,000,000 to settle allegations that they violated the False Claims Act by engaging in improper financial relationships with referring physicians, the Justice Department announced today. The two Defendants are Mercy Hospital Springfield f/k/a St. John’s Regional Health Center, and its affiliate, Mercy Clinic Springfield Communities f/k/a St. John’s Clinic. Among other health care facilities, the Defendants operate a hospital, clinic, and infusion center in Springfield, Missouri.
The settlement announced today resolved allegations that the Defendants submitted false claims to the Medicare Program for chemotherapy services rendered to patients referred by oncologists whose compensation was based in part on a formula that improperly took into account the value of their referrals of patients to the infusion center operated by the Defendants. Federal law restricts the financial relationships that hospitals and clinics may have with doctors who refer patients to them.
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The Government announced that the whistleblower, a former physician at one of the two hospitals, will be paid $5.44 million (a 16% relator’s share).
