Mercy Health Springfield Communities and its affiliate Mercy Clinic Springfield Communities will pay $5.5 million to settle a lawsuit with the U.S. Department of Justice, which claimed the companies had improper financial relationships with referring physicians.
Both health facilities operate facilities in Missouri. The lawsuit claimed the two health care facilities submitted false Medicare claims for services given to patients and referred by physicians. The physicians allegedly received bonuses based on formulas that didn't improperly took the value of those referrals.
“Financial relationships between heath care providers and their referral sources must be structured to comply with all applicable laws,” said Principal Deputy Assistant Attorney General Benjamin Mizer, the head of the Justice Department’s Civil Division. “When physicians are rewarded financially for referring patients to hospitals or other health care providers, it can affect their medical judgment, resulting in overutilization of services that drives up health care costs for everyone.”
Mizer added the recovered funds for taxpayers and settlement with the health care facilities should deter similar conduct by other facilities in the future.
Dr. Jean Moore, who worked at the facilities, filed a whistleblower lawsuit against her employer. Moore will receive $825,000 from the recovery, the DOJ said.