The following provider lawsuits, settlements or legal developments were reported within the past month, beginning with the most recent.
1. Judge Still Undecided on WakeMed's Proposed Settlement
As of Feb. 6, U.S. District Judge Terrence Boyle said he hasn't decided whether he will approve an $8 million settlement between Raleigh, N.C.-based WakeMed Health & Hospitals and federal prosecutors, as he still has significant concerns about the scope of the deal. This isn't the first time Judge Boyle has expressed uncertainty about WakeMed's settlement proposal. Last month, he called the proposal "a slap on the hand" for the 870-bed health system's alleged false claims to Medicare. https://www.beckershospitalreview.com/legal-regulatory-issues/judge-wakemeds-settlement-proposal-too-small-for-false-claims-allegations.html
2. Methodist Medical Center of Illinois Files Antitrust Suit Against OSF Healthcare
Methodist Medical Center of Illinois in Peoria filed an antitrust lawsuit against OSF Healthcare's Saint Francis Medical Center, also in Peoria, on Feb. 5. In its suit, Methodist claims OSF has engaged in anticompetitive and exclusionary conduct affecting "several major commercial insurers" that violates federal antitrust laws as well as provisions of Illinois law.
3. Renown Health Pays $4.2M to Cardiologists Under Settlement
Under a settlement with Reno, Nev.-based Renown Health, 12 cardiologists received a combined $4.2 million Feb. 5 and the option to leave Renown for another hospital or clinic without facing penalties. The settlement stems from a Federal Trade Commission ruling in December, in which the agency said Renown's non-compete clauses with cardiologists led the system to have a monopoly-like hold on heart care in the Reno-Sparks area.
4. Radiologists Claim Bozeman Deaconess Hospital in Montana Created Monopoly
Two radiologists filed suit against Bozeman (Mont.) Deaconess Hospital, claiming the hospital breached a joint venture contract, created a monopoly and forced the physicians out of practice. Frank Rembert, MD, Michael Paradise, MD, and Bozeman Radiology filed the suit in late January.
5. Minnesota Supreme Court: Online Criticism About Physician is Not Defamation
The Minnesota Supreme Court ruled that a man's online criticism of a physician is protected speech. The high court dismissed a case brought by neurologist David McKee, MD, after a patient's son posted critical comments about him on a website featuring physician ratings.
6. Cooper Health in N.J. Agrees to $12.5M Settlement for Alleged Kickbacks
Camden, N.J.-based Cooper Health System agreed to a $12.5 million settlement to resolve federal and state allegations of kickbacks. The system allegedly violated the False Claims Act by making improper payments to physicians for "consulting" and "compensation" agreements, according to the report. These payments were allegedly made while Cooper Health was building its cardiology program.
7. Judge Orders HCA to Pay Health Care Foundation $161.9M
Nashville, Tenn.-based Hospital Corporation of America was ordered to pay the Health Care Foundation of Greater Kansas City (Mo.) $161.9 million to fulfill obligations it accepted when it bought Health Midwest in Kansas City.
8. Supreme Court Rejects Hospitals' Suit Over Disproportionate Share Payments
The U.S. Supreme Court issued a unanimous opinion on Jan. 22 that reversed and remanded a circuit court ruling that hospitals could appeal decisions by the Provider Reimbursement Review Board that are up to 25 years old. A group of 18 hospitals challenged their Medicare disproportionate share adjustments for 1987 through 1994 after the PRRB identified flaws in CMS' methodology in 2006. The high court ruled the hospitals missed their opportunity to appeal the reimbursement.
9. Jackson Purchase Medical Center Settles False Claims Charges With $850k
Jackson Purchase Medical Center in Mayfield, Ky., agreed to pay more than $850,000 to resolve claims it falsely billed Medicare. The Department of Justice claimed the hospital provided an orthopedic perks in exchange for his referrals to the hospital. The DOJ claimed the hospital submitted claims for those patients to Medicare.
10. Wayne Medical Center in Tennessee Agrees to $883k Settlement
Wayne Medical Center in Waynesboro, Tenn., agreed to pay $883,451 to resolve false claims allegations after it voluntarily disclosed improper billing to federal officials. WMC's self-disclosure prompted an investigation into the hospital's billing for ambulance transports as part of its emergency medical services. The United States claimed WMC submitted certain claims and received payment for ambulance services with several documentation problems.
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1. Judge Still Undecided on WakeMed's Proposed Settlement
As of Feb. 6, U.S. District Judge Terrence Boyle said he hasn't decided whether he will approve an $8 million settlement between Raleigh, N.C.-based WakeMed Health & Hospitals and federal prosecutors, as he still has significant concerns about the scope of the deal. This isn't the first time Judge Boyle has expressed uncertainty about WakeMed's settlement proposal. Last month, he called the proposal "a slap on the hand" for the 870-bed health system's alleged false claims to Medicare. https://www.beckershospitalreview.com/legal-regulatory-issues/judge-wakemeds-settlement-proposal-too-small-for-false-claims-allegations.html
2. Methodist Medical Center of Illinois Files Antitrust Suit Against OSF Healthcare
Methodist Medical Center of Illinois in Peoria filed an antitrust lawsuit against OSF Healthcare's Saint Francis Medical Center, also in Peoria, on Feb. 5. In its suit, Methodist claims OSF has engaged in anticompetitive and exclusionary conduct affecting "several major commercial insurers" that violates federal antitrust laws as well as provisions of Illinois law.
3. Renown Health Pays $4.2M to Cardiologists Under Settlement
Under a settlement with Reno, Nev.-based Renown Health, 12 cardiologists received a combined $4.2 million Feb. 5 and the option to leave Renown for another hospital or clinic without facing penalties. The settlement stems from a Federal Trade Commission ruling in December, in which the agency said Renown's non-compete clauses with cardiologists led the system to have a monopoly-like hold on heart care in the Reno-Sparks area.
4. Radiologists Claim Bozeman Deaconess Hospital in Montana Created Monopoly
Two radiologists filed suit against Bozeman (Mont.) Deaconess Hospital, claiming the hospital breached a joint venture contract, created a monopoly and forced the physicians out of practice. Frank Rembert, MD, Michael Paradise, MD, and Bozeman Radiology filed the suit in late January.
5. Minnesota Supreme Court: Online Criticism About Physician is Not Defamation
The Minnesota Supreme Court ruled that a man's online criticism of a physician is protected speech. The high court dismissed a case brought by neurologist David McKee, MD, after a patient's son posted critical comments about him on a website featuring physician ratings.
6. Cooper Health in N.J. Agrees to $12.5M Settlement for Alleged Kickbacks
Camden, N.J.-based Cooper Health System agreed to a $12.5 million settlement to resolve federal and state allegations of kickbacks. The system allegedly violated the False Claims Act by making improper payments to physicians for "consulting" and "compensation" agreements, according to the report. These payments were allegedly made while Cooper Health was building its cardiology program.
7. Judge Orders HCA to Pay Health Care Foundation $161.9M
Nashville, Tenn.-based Hospital Corporation of America was ordered to pay the Health Care Foundation of Greater Kansas City (Mo.) $161.9 million to fulfill obligations it accepted when it bought Health Midwest in Kansas City.
8. Supreme Court Rejects Hospitals' Suit Over Disproportionate Share Payments
The U.S. Supreme Court issued a unanimous opinion on Jan. 22 that reversed and remanded a circuit court ruling that hospitals could appeal decisions by the Provider Reimbursement Review Board that are up to 25 years old. A group of 18 hospitals challenged their Medicare disproportionate share adjustments for 1987 through 1994 after the PRRB identified flaws in CMS' methodology in 2006. The high court ruled the hospitals missed their opportunity to appeal the reimbursement.
9. Jackson Purchase Medical Center Settles False Claims Charges With $850k
Jackson Purchase Medical Center in Mayfield, Ky., agreed to pay more than $850,000 to resolve claims it falsely billed Medicare. The Department of Justice claimed the hospital provided an orthopedic perks in exchange for his referrals to the hospital. The DOJ claimed the hospital submitted claims for those patients to Medicare.
10. Wayne Medical Center in Tennessee Agrees to $883k Settlement
Wayne Medical Center in Waynesboro, Tenn., agreed to pay $883,451 to resolve false claims allegations after it voluntarily disclosed improper billing to federal officials. WMC's self-disclosure prompted an investigation into the hospital's billing for ambulance transports as part of its emergency medical services. The United States claimed WMC submitted certain claims and received payment for ambulance services with several documentation problems.
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