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Sunday, August 18, 2019

U.S. OKs $34,000 settlement with Missouri health care providers

By Mark Iandolo | May 23, 2017

KANSAS CITY, Mo. (Legal Newsline) — The U.S. Department of Justice announced May 18 that two southwest Missouri health care providers will pay $34,000 after allegations of violating the False Claims Act through the creation of improper financial relationships with referring physicians.

“When physicians are rewarded financially for referring patients to hospitals or other health care providers, it can affect their medical judgment, resulting in over-utilization of services that drives up health care costs for everyone,” said acting assistant attorney general Chad A. Readler of the Justice Department’s Civil Division.  “In addition to yielding a recovery for taxpayers, this settlement should deter similar conduct in the future and help make health care more affordable.”

The two defendants are Mercy Hospital Springfield, formerly known as St. John’s Regional Health Center, and its affiliate, Mercy Clinic Springfield Communities, formerly known as St. John’s Clinic. According to allegations, the defendants used a formula to compensate physicians who referred patients for chemotherapy services based on the value of their referrals.

“This settlement protects patients and the public by enforcing the federal protections against profit incentives for physicians,” said acting U.S. attorney Thomas M. Larson for the Western District of Missouri.  “Patients deserve assurances that they are receiving appropriate medical care, unbiased by hidden incentives.  And taxpayers deserve assurances that the cost of public health care programs is not inflated by unnecessary procedures and services.”

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