Vanguard to pay $2.9M in false claims, kickback settlement

Feds allege violations occurred before Tenet bought company
Jun 15, 2015 1:00 PM

HCA to pay $2.3M in Medicare fraud settlement

HCA Holdings will pay $2.3 million to the federal government in a Medicare fraud settlement.

According to The Wall Street Journal, four HCA hospitals are among nine facilities accused of benefiting from medically unnecessary ambulance rides.

The nine hospitals, which include Jacksonville-based Baptist Health facilities and a University of Florida hospital, will pay a total of $7.5 million to settle allegations that non-emergency patients were being transported from hospitals to residences and nursing homes in ambulances.

The hospitals didn’t directly profit from the ambulance rides at issue because ambulance companies bill Medicare themselves for rides they provide, but prosecutors found that the hospitals benefited indirectly by speeding up their admissions and discharges—a key contributor to hospital profitability dubbed “throughput."

For more, click here.

Shares of HCA (Ticker: HCA) were up 1 percent to $80.72 Monday morning. Year to date, they're up almost 10 percent.

May 18, 2015 2:10 PM

CHS to pay $15.2M in False Claims settlement

The Department of Justice and the owners of 16 hospitals have reached an agreement to settle False Claims Act allegations related to their use of intensive outpatient psychotherapy services from 2005 to 2013. The federal authorities claim the organizations didn't meet various requirements for Medicare billing.

Of the hospitals, 14 were under the banner of Health Management Associates until early last year and are now owned by Community Health Systems. A 15th hospital in Mississippi also is owned by CHS, while the last of the bunch is a 60-bed facility in North Texas. CHS will pay $210,000 for the Mississippi settlement while HMA's tab runs to $15 million.

“This case demonstrates that the U.S. Attorney’s Office for the Eastern District of Arkansas will aggressively pursue civil health care fraud cases, where the integrity of the Medicare system has been undermined,” said U.S. Attorney Christopher Thyer of the Eastern District of Arkansas. “Medical care providers who abuse Medicare hurt all taxpayers, and today’s announcement highlights our commitment to protecting our national health care system, as well as the Arkansans who depend on it.”

Read the full DOJ statement here.

May 8, 2015 7:27 AM

Reports: DOJ's Public Integrity chief heading to Nashville

Jack Smith to be Rivera's No. 2
Jan 26, 2015 2:00 PM

CareAll to pay $25M in False Claims Act settlement

Overbilling allegations lead to second fine in three years
Nov 12, 2014 1:22 PM

14-year sentence for Hanover scheme CEO

The man who orchestrated an $18 million Ponzi scheme that defrauded about 150 investors in the middle of the last decade has been sentenced to 14 years in prison and ordered to repay almost all of his ill-gotten gains. Gallatin native Terry Kretz pleaded guilty to fraud charges early this year and will be subject to three years of supervised release following his time in prison. Co-conspirators Robert Haley and Daryl Bornstein are scheduled to be sentenced next week.

Kretz told clients that their money would be used for specific purposes, such as investing in stock options and startup companies. In fact, however, more than half of the money invested in Hanover went to repay earlier investors, to pay Hanover’s salaries and overhead and to fund personal luxuries, including Kretz’s purchase of a $600,000 residential building lot, a $176,000 contribution to a church, and golf memberships.

Aug 18, 2014 7:11 AM

CHS to pay $98M in false claims settlement

Agreement with DOJ ends investigation into improper billing practices
Aug 5, 2014 7:00 AM

Pilot strikes deal with feds

Pilot Flying J avoids prosecution related to its alleged diesel rebate fraud scheme, but does not avoid paying $92 million. The deal comes after the company also agreed to pay $85 million to a number of trucking companies.

According to a news release from the U.S. Attorney for Eastern Tennessee, the agreement “expressly states that it provides no protection from prosecution to any individual, and moreover, imposes a continuing obligation on Pilot to provide complete cooperation with the ongoing federal investigation of current and former Pilot employees relating to fraudulent conduct involving the sale of diesel fuel.”

Here's a letter from the DOJ detailing the agreement.

Jul 14, 2014 12:37 PM

Iasis, feds extend review of cardiac implants

Franklin-based hospital operator one of many under large Medicare investigation
May 19, 2014 7:00 AM

LP, Ainsworth spike deal

With lengthy litigation looming, companies call off $1.1B plan
May 14, 2014 12:47 PM