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A settlement has been reached in relation to two whistleblower class action lawsuits brought against Columbus Regional Healthcare System (Columbus Regional) and Dr. Andrew Pippas.  They are accused of submitting claims in violation of the Stark Law and submitting claims for payment to federal health care programs that misrepresented the level of services they provided. 

Under the settlement agreement, of the $25.425 million that Columbus Regional and Pippas have agreed to pay to resolve their respective civil claims, they will pay $24,666,040 to the federal government for federal healthcare program losses and $758,960 to the state of Georgia for the state share of its Medicaid losses, plus additional contingent payments not to exceed $10 million, for a maximum settlement amount of $35 million.The whistleblower's recovery amount was not disclosed.

The first of the two lawsuits was filed in May 2012.  The lawsuits alleged that that from May 2006 through May 2013, Columbus Regional submitted claims to federal health care programs for services at higher levels than supported by the documentation, and between 2010 and 2012, they submitted claims to federal health care programs for radiation therapy at higher levels than the therapy that was provided.

A settlement has been reached to resolve False Claims Act allegations against Detroit Medical Center who is accused of engaging in improper financial relationships with referring physicians.

The government learned of the statutory violations from Detroit Medical Center, itself, which discovered improper financial relationships with a number of physicians as it prepared for the sale to Vanguard Health Systems Inc.

A settlement has been reached in a whistleblower class action lawsuit brought against Mercy Health Springfield Communities, formerly known as St. John’s Health System Inc., and Mercy Clinic Springfield Communities, formerly known as St. John’s Clinic.  They are accused of engaging in improper financial relationships with referring physicians.

The whsitleblower will receive $825,000 from the recovery.

Originally filed in 2013, the lawsuit allges that the defendants submitted false claims to the Medicare program for services rendered to patients referred by physicians who received bonuses based on a formula that improperly took into account the value of the physicians’ referrals of patients to the clinic.  Federal law restricts the financial relationships that hospitals and clinics may have with doctors who refer patients to them.