Hospital pays $3.8M to resolve allegations it assisted cardiologist in exchange for patient referrals
A hospital in Manchester, New Hampshire, has agreed to pay $3.8 million to resolve allegations that it provided certain services to a cardiologist in exchange for patient referrals.
Catholic Medical Center (CMC) is accused of paying its own team of doctors to cover for another cardiologist in exchange for patient referrals worth “millions of dollars” from that cardiologist. CMC’s physicians, the United States alleged, even treated the cardiologist’s patients when necessary.
CMC submitted payment claims for these services to Medicare, Medicaid and other U.S. healthcare programs.
“The False Claims Act and the Anti-Kickback Statute protect patients and federal healthcare programs from fraud and abuse by removing the corrupting influence of money,” U.S. Attorney for the District of New Hampshire John J. Farley said in a prepared statement. “When patients are referred for medical services, those referrals should be based solely on medical need and not affected by financial considerations. We work closely with our law enforcement partners to protect the integrity of federal healthcare programs and we will use all appropriate enforcement tools to combat healthcare fraud in New Hampshire.”
“Kickback schemes can undermine our healthcare system, compromise medical decisions, and waste taxpayer dollars,” added Joseph R. Bonavolonta, special agent in charge of the FBI Boston Division. “As today’s settlement makes clear, the FBI will aggressively investigate those who seek to bolster their bottom line by paying illegal kickbacks — whether directly or indirectly — to circumvent safeguards designed to protect the integrity of federal healthcare programs.”
As part of the settlement, CMC did not admit liability for its alleged actions.
David Goldberg, MD, a former CMC employee, was the whistleblower who first brought this alleged relationship to the attention of the United States. He will receive a portion of the final settlement.
Representatives from the Office of Inspector General of the U.S. Department of Health and Human Services, the Office of Inspector General of the Department of Defense and the FBI all helped work on this case.
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