United States intervenes in whistleblower’s complaint against West Virginia hospital, management company, CEO

by Ben Vernia | March 27th, 2019

On March 25, the Department of Justice announced that it had filed a complaint in intervention of a whistleblower’s case against Wheeling (West Virginia) Hospital, Inc., its management company and CEO. According to DOJ’s press release:

The United States filed a complaint under the False Claims Act against Wheeling Hospital Inc., R & V Associates Ltd. (R & V), and Ronald Violi in the U.S. District Court for the Western District of Pennsylvania, the Department of Justice announced today. The government alleges that Wheeling Hospital, which is located in Wheeling, West Virginia, violated the Stark Law and Anti-Kickback Statute, and that those violations were caused by R & V, Wheeling’s contracted management consultant, and Violi, Wheeling’s CEO.

The Stark Law prohibits a hospital from billing Medicare for services referred by physicians who have improper financial relationships with the hospital.  The Anti‑Kickback Statute prohibits offering or paying anything of value to induce the referral of items or services covered by Medicare, Medicaid, and other federal healthcare programs.  The United States alleges that Wheeling’s compensation to a number of employed and contracted physicians violated these statutory prohibitions because that compensation was based on the volume or value of the physicians’ referrals or exceeded the fair market value of the physicians’ services.

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The United States filed its complaint in a lawsuit filed under the qui tam, or whistleblower, provisions of the False Claims Act.  Those provisions authorize private parties to sue on behalf of the United States for false claims and share in any recovery.  The Act permits the United States to intervene and take over the lawsuit, as it did here in part.

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