FLORIDA
A doctor who sued a hospital under the Whistleblower’s Act alleging improper financial relations the hospital had with physicians will get $12 million, the federal government announced today.
Under the act, private citizens can bring suit on behalf of the government for false claims and share in any recovery. Dr. Michael Reilly will receive $12 million from the $69.5 million recovery, according to officials.
North Broward Hospital District, a special taxing district of the state of Florida that operates hospitals and other health care facilities in the Broward County, agreed to pay the federal government $69.5 million to settle a lawsuit, officials said.
The federal government alleged that the hospital violated the False Claims Act by engaging in improper financial relationships with referring physicians, the Justice Department officials.
The claims settled by this agreement are allegations only, and there has been no determination of liability, officials said.
“The Department of Justice has long-standing concerns about improper financial relationships between health care providers and their referral sources, because those relationships can alter a physician’s judgment about the patient’s true health care needs and drive up health care costs for everybody,” said Deputy Assistant Attorney General Benjamin C. Mizer, head of the Justice Department’s Civil Division.
Adding, “In addition to yielding a recovery for taxpayers, this settlement should deter similar conduct in the future and help make health care more affordable.”
The settlement announced today resolved allegations that the hospital district provided compensation to nine employed physicians that exceeded the fair market value of their services, officials said.
The federal government contended that these agreements violated the Stark Statute and the False Claims Act. The Stark Statute restricts the financial relationships that hospitals may have with doctors who refer patients to them, according to officials.
“Improper financial rewards given to physicians in exchange for patient referrals corrupts medical decision making and inflates health care costs,” said Special Agent in Charge Shimon R. Richmond of the U.S. Department of Health and Human Services-Office of Inspector General (HHS-OIG). “Our agency will continue to root out such behavior from our health care system.”
One of the most powerful tools in this effort is the False Claims Act.
Since January 2009, the Justice Department has recovered a total of more than $25 billion through False Claims Act cases, with more than $16 billion of that amount recovered in cases involving fraud against federal health care programs, officials said.
The case, United States ex rel. Reilly v. North Broward Hospital District, et al., Case No. 10-60590 was handled by the Civil Division’s Commercial Litigation Branch, the U.S. Attorney’s Office of the Southern District of Florida and the HHS-OIG, according to authorities.