Boston-based Steward Health Care and one of its largest affiliated physician groups, Compass Medical Group of East Bridgewater (Mass.), are suing one another for fraud and breach of contract over millions of dollars in physician payments.
Here are six things to know about the lawsuits.
1. Compass filed suit against Steward, claiming the for-profit system has failed to make incentive payments since 2013, according to The Boston Globe. The payments are mandatory bonuses that are supposed to be paid to physicians for hitting quality targets, which were unspecified in the lawsuit. Steward allegedly withheld the payments because they surpassed fair-market value for services, according to the report. The physician group questioned this claim, but Steward allegedly never followed through on its promise to review it, according to a report from CommonWealth Magazine.
2. The physician group also claims Steward fell behind on rent and equipment leases. Compass claims Steward owes at least $1.4 million in late rent and equipment lease payments, according to CommonWealth Magazine.
3. Compass filed the Chapter 93A lawsuit in the Suffolk Superior Court for $20 million. Under this statute, the jury could triple the award to $60 million if it decides in favor of the plaintiff.
4. Steward filed a counter-lawsuit against Compass for fraud and breach of contract. The health system claims the group held onto $3.5 million in overpayments and would not return the money to Steward. It also claims Compass executives dodged negotiation discussions, even after bringing in the Department of Justice, according to The Boston Globe.
5. Steward also claims Compass engaged in "deceptive financial practices," according to CommonWealth Magazine. The health system claims Compass billed for non-physician providers at the same rate it did for physicians, according to the report. Both parties claim the other has withheld financial information, according to The Boston Globe.
6. The health system and physician group have been partners since 2012.The group has 104 providers, CommonWealth Magazine reported, and about 50 of those are physicians, according to The Boston Globe. Compass operates independently, but coordinates care for patients with the health system and refers patients to its hospitals. Under the arrangement, Steward is responsible for managing claims and paying physicians, according to the Globe report.
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