The Health Alliance of Greater Cincinnati, two of its member hospitals — Fort Hamilton Hospital and University Hospital — and University Internal Medicine Associates have agreed to pay the United States $2.6 million to settle claims that they violated the Anti-Kickback Statute and the False Claims Act, according to a Department of Justice news release.
The groups allegedly participated in a scheme to refer patients to UIM Associates in return for the practice providing coverage for Fort Hamilton's limited cardiology services. Under state law, Fort Hamilton could only perform the interventional cardiology procedures if it participated in a particular clinical trial involving those procedures. UIM Associates allegedly offered to provide the interventional cardiology coverage that Fort Hamilton needed for the clinical trial, but only if the hospital agreed to refer cardiology patients and procedures to the physician group on a preferential basis. The government contended that the preferential referral arrangements sometimes resulted in patients being transferred to University Hospital, or being seen by cardiologists with University Internal Medicine Associates, rather than the hospital or cardiologist of their choosing.
The government argued this arrangement violated the federal Anti-Kickback Statute, which prohibits a healthcare providers from soliciting or receiving anything of value in return for patient referrals. The government also alleged that the claims the hospitals and the physician group submitted to Medicare as a result of this illegal kickback scheme violated the False Claims Act.
The allegations resolved by the settlement were initiated by a whistleblower lawsuit filed by Deborah Hauger, MD, a cardiologist who formerly worked at Fort Hamilton Hospital.
Read the DOJ release on the Health Alliance of Greater Cincinnati settlement.
Read Becker's coverage on previous Health Alliance of Greater Cincinnati settlements.
The groups allegedly participated in a scheme to refer patients to UIM Associates in return for the practice providing coverage for Fort Hamilton's limited cardiology services. Under state law, Fort Hamilton could only perform the interventional cardiology procedures if it participated in a particular clinical trial involving those procedures. UIM Associates allegedly offered to provide the interventional cardiology coverage that Fort Hamilton needed for the clinical trial, but only if the hospital agreed to refer cardiology patients and procedures to the physician group on a preferential basis. The government contended that the preferential referral arrangements sometimes resulted in patients being transferred to University Hospital, or being seen by cardiologists with University Internal Medicine Associates, rather than the hospital or cardiologist of their choosing.
The government argued this arrangement violated the federal Anti-Kickback Statute, which prohibits a healthcare providers from soliciting or receiving anything of value in return for patient referrals. The government also alleged that the claims the hospitals and the physician group submitted to Medicare as a result of this illegal kickback scheme violated the False Claims Act.
The allegations resolved by the settlement were initiated by a whistleblower lawsuit filed by Deborah Hauger, MD, a cardiologist who formerly worked at Fort Hamilton Hospital.
Read the DOJ release on the Health Alliance of Greater Cincinnati settlement.
Read Becker's coverage on previous Health Alliance of Greater Cincinnati settlements.