Following self-disclosure, West Virginia hospital settles self-referral fraud allegations

by Ben Vernia | July 10th, 2022

On July 7, the Department of Justice announced that a Weirton, West Virginia, hospital had agreed to pay $1.5 million to resolve allegations that the hospital had violated the Stark Law, which it had self-disclosed to the Government. According to DOJ’s press release:

Weirton Medical Center, a hospital located in Weirton, West Virginia, has agreed to pay $1.5 million to resolve allegations that it violated the False Claims Act by knowingly submitting or causing the submission of claims to Medicare in violation of the Physician Self-Referral Law (commonly referred to as the Stark Law).

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The settlement, which is based on the hospital’s financial condition, stems from a voluntary self-disclosure made by the hospital regarding potential Stark Law violations. The Stark Law prohibits a hospital from billing Medicare for certain services referred by physicians with whom the hospital has a financial relationship, unless that relationship satisfies one of the law’s statutory or regulatory exceptions. The Stark Law is intended to ensure that medical decision-making is not compromised by improper financial incentives and is instead based on the best interests of the patient. The settlement resolves Weirton Medical Center’s liability under the False Claims Act for submitting claims to Medicare that resulted from violations of the Stark Law due to payment of compensation to referring physicians that allegedly exceeded fair market value or took into account the volume or value of the physicians’ referrals to the hospital.

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