Part of the settlement includes a five-year corporate integrity agreement subjecting the organization to a yearly financial review.
Steward Health Care System—a Dallas-based private for-profit healthcare network with over $180 million in revenue—has agreed to pay over $4 million to resolve allegations of fraud.
Steward and some of its affiliates have agreed to pay $4.7 million to settle a lawsuit claiming that relationships it had with several physicians and physician practice groups violated federal law, including the False Claims Act, which makes it a crime for a person or organization to knowingly make a false record or file a false claim relating to a federal healthcare program.
Steward is one of the largest, private for-profit healthcare networks in the U.S. and owns several hospitals in Massachusetts, including the for-profit hospital Good Samaritan Medical Center. The settlement agreement states that in 2011 Good Samaritan Medical Center entered into an agreement with Brockton Urology Clinic in which Brockton would administer prostate cancer centers of excellence at Good Samaritan Medical Center. However, Good Samaritan Medical Center has admitted that since January of 2012, they had no such centers of excellence. It is alleged that from April 2011 through December 2017 Good Samaritan Medical Center paid Brockton Urology pursuant to the agreement and Brockton Urology referred patients to Good Samaritan Medical Center.
"This case is about fraud, waste, and abuse by Steward at the expense of the American taxpayers,” United States Attorney Rachael Rollins said in a release announcing the settlement. "When hospitals like Steward violate the law, we will work tirelessly to recover from them taxpayer money in order to ensure that Medicare and Medicaid funds are going to treat patients instead of supporting fraud."
The U.S. and Brockton Urology had reached a separate settlement in February of this year. Brockton agreed to pay $100,000 to resolve allegations it violated the False Claims Act.
"This settlement should serve as a warning to hospitals that they should not pay referring doctors for services that they did not provide,” Joseph Bonavolonta, Special Agent in Charge of the FBI Boston Division, said in the Good Samaritan Medical Center statement. "Here a hospital paid referring physicians under the guise of a bogus cancer center. The FBI is proud to work alongside our partners to make sure hospitals follow the law and to root out fraud anywhere in the system."
As part of the settlement Good Samaritan Medical Center has signed a five-year corporate integrity agreement with the Department of Health and Human Services, Office of Inspector General. As part of this agreement each year Good Samaritan Medical Center will be subjected to an annual review of its financial arrangements to ensure compliance with the Anti-Kickback Statute and the Stark Law.
"Financial and referral arrangements between hospitals and physician practices that violate federal health care laws undermine the integrity of crucial medical decision-making," Phillip Coyne, Special Agent in Charge of HHS-OIG said. "This settlement is an example of the government’s combined efforts to protect Federal health care programs and their beneficiaries from those who are alleged to have violated these laws."
Amanda Schiavo is the Finance Editor for HealthLeaders.