Cincinnati health alliance, Christ Hospital settle suit for $108M

The Health Alliance of Greater Cincinnati and The Christ Hospital have settled a whistleblower lawsuit […]

The Health Alliance of Greater Cincinnati and The Christ Hospital have settled a whistleblower lawsuit accusing the hospital of defrauding federal healthcare programs by making improper payments to cardiologists in exchange for generating hospital revenue.

The health alliance and hospital signed a civil settlement agreement with the U.S. Department of Justice to resolve the manner in which physicians were assigned to work in the hospital’s cardiac testing station — the Heart Station — from 1997 to 2004, according to a written statement from Christ Hospital.

The Justice Department, which joined the whistleblower suit in 2008, called the hospital’s work assignment practices an “illegal kickback scheme.” The government had sought an award of more than $1 billion, according to Susan Croushore, president and CEO of Christ Hospital. The hospital will pay part of the $108 million settlement so that it can “move forward without years of ongoing litigation and the risk of a crippling judgment,” Croushore said in the hospital’s statement.

“While The Christ Hospital continues to disagree with the government’s allegations that the assignment of physicians to our cardiac testing station resulted in the inducement of local cardiologists to refer patients to the hospital, we decided to contribute to the joint settlement agreement with the Health Alliance of Greater Cincinnati instead of risking a potential catastrophic judgment that could jeopardize our ability to provide service to this community,” Croushore said.

Dr. Harry Fry, the cardiologist who filed the whistleblower suit against the Mount Auburn, Ohio, hospital, will get $23.5 million, the Justice Department said in a Friday statement.

Christ Hospital ran into trouble by assigning time in its outpatient cardiology unit only to cardiologists who referred business to the hospital, the Justice Department said. Cardiologists whose referrals earned at least 2 percent of the hospital’s annual revenues were rewarded with a related amount of time at the Heart Station, the government said.

There, the cardiologists had the opportunity to earn additional income by billing for patients they treated at the unit and for follow-up procedures.

The government said using lucrative cardiac referrals to assign physicians to the Heart Station violated the federal Anti-Kickback Statute. Meanwhile, claims the hospital submitted to Medicare and Medicaid throm the illegal kickback scheme violated the False Claims Act.

“We provided necessary and often life-saving medical care by ensuring sufficient cardiologists coverage to read heart tests provided in the hospital,” Croushore said in Christ Hospital’s statement. “There was no challenge in this case to the medical necessity or quality of patient care. Nor did the government suffer any loss, as it did not expend any money for the services beyond standard Medicare payments.”

A lot has changed since Fry complained about Christ Hospital’s cardiologist-assigning practices. Christ Hospital no longer belongs to the Greater Cincinnati health alliance. And the health alliance fell to just one hospital earlier this year when its members agreed to dissolution.

http://www.justice.gov/opa/pr/2010/May/10-civ-602.html

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