🩺💸 Kickbacks, Cuts & Corporate Curveballs: What’s Shaking Up Healthcare This Week

Fresno Health System Pays $31.5M Over Kickback Allegations

Community Health System (CHS) and its affiliate Physician Network Advantage Inc. (PNA) have agreed 🤝 to pay $31.5 million to resolve allegations of violating the False Claims Act by providing financial incentives to physicians for patient referrals.

Key Points

• CHS and PNA allegedly provided lavish gifts, including access to a luxury lounge with expensive wine and cigars, to physicians in exchange for patient referrals.

• The alleged misconduct included offering financial subsidies for electronic health records technology to certain physicians, purportedly to encourage referrals to CHS facilities.

• Whistleblower Michael Terpening, a former PNA controller, filed a qui tam lawsuit that led to the settlement and will receive approximately $5 million as part of the agreement.

• As part of the settlement, CHS has entered into a five-year Corporate Integrity Agreement with the U.S. Department of Health and Human Services Office of Inspector General to implement compliance measures and undergo annual reviews.

Why It Matters

This settlement underscores the importance of compliance with federal laws prohibiting financial arrangements that can influence medical decision-making. Healthcare organizations must ensure that their relationships with physicians do not involve improper inducements that could compromise patient care.

Takeaway

Healthcare entities should review and strengthen their compliance programs to prevent and detect potential violations of the Anti-Kickback Statute and the Stark Law, thereby safeguarding the integrity of patient referrals and maintaining trust in healthcare systems.