Baxter Regional Medical Center in Mountain Home, Ark., is seeking $15 million in damages from a Texas management firm that BRMC claims violated federal physician self-referral statutes, according to a Baxter Bulletin report.
BRMC claims that Horizon Mental Health Management, a firm in charge of BRMC's behavioral health center, may not have secured proper service contracts with medical directors and thus violated a section of the Social Security Act prohibiting self-referral for Medicare reimbursements.
According to the lawsuit cited in the report, direct compensation arrangements between Baxter and physicians "did not precisely fit within the requirements of applicable exception" and "physicians' referrals and Baxter's submissions of claims based on these referrals may constitute a violation of the physician Self-Referral statute." The alleged contractual omissions left BRMC forced to self-report Horizon's violations to CMS, according to the report.
The hospital is awaiting word from CMS concerning the financial consequences of the possible violations.
The lawsuit also contains other allegations, according to the report, such as claims that Horizon failed in on-site contractual requirements and failed to provide a nurse manager in 2008.
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BRMC claims that Horizon Mental Health Management, a firm in charge of BRMC's behavioral health center, may not have secured proper service contracts with medical directors and thus violated a section of the Social Security Act prohibiting self-referral for Medicare reimbursements.
According to the lawsuit cited in the report, direct compensation arrangements between Baxter and physicians "did not precisely fit within the requirements of applicable exception" and "physicians' referrals and Baxter's submissions of claims based on these referrals may constitute a violation of the physician Self-Referral statute." The alleged contractual omissions left BRMC forced to self-report Horizon's violations to CMS, according to the report.
The hospital is awaiting word from CMS concerning the financial consequences of the possible violations.
The lawsuit also contains other allegations, according to the report, such as claims that Horizon failed in on-site contractual requirements and failed to provide a nurse manager in 2008.
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