Georgia's Columbus Regional Hospital System to pay $25 million to settle kickback charges

Columbus Regional Hospital image from CRH.org.

The Columbus Regional Hospital System in Georgia has agreed to pay the state and federal governments $25 million, and potentially another $10 million, to resolve allegations that it overbilled Medicare and paid kickbacks to a medical director for referrals, according to Georgia Attorney General Sam Olens in a Sept. 4 announcement.

The civil settlement resolves allegations that the hospital system submitted claims to the state for evaluation and management services billed at higher levels than supported by documentation, for radiation therapy that did not qualify as such, and for claims submitted in violation of rules prohibiting payment in return for the referral of Medicaid patients.

Georgia also reached a civil resolution with Dr. Andrew Pippas, a medical oncologist employed by the hospital who also serves as a medical director at the John B. Amos Cancer Center.

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Pippas will pay Georgia and the United States $425,000 to settle allegations that he received improper salary and medical directorship payments from Columbia Regional Hospital System resulting in the illegal submission of claims by the hospital to Medicare and Medicaid, according to the Attorney General's Office.

The case began with a lawsuit filed in May 2012 by whistleblower Richard Barker, who joined the cancer center in 2011 as administrative director.

The civil settlement resolves the lawsuit, and makes no determination of liability.

The agreement involves Columbus Regional Hospital System, The Medical Center, including the John B. Amos Cancer Center, Columbus Regional Oncology Treatment Center, and Regional Oncology, LLC. The defendants have agreed to pay Georgia and the United States $25 million and may pay another $10 million contingent upon certain financial conditions, according to the AG's Office.

In addition, on Sept. 5, another large nonprofit provider in Columbus, Georgia, St. Francis Hospital, was told it had to repay the federal government $21.4 million, according to a published source. This was after St. Francis said it could not account for about $30 million on its financial books, according to the Atlanta Journal-Constitution referring to a story published in the Columbus Ledger-Enquirer.

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A federal audit said St. Francis Hospital management did not comply with regulations and a regulatory agreement connected to the financing of its $252 million expansion and campus renovation, completed in 2013, the Ledger-Enquirer reported.

Originally terming the $30 million financial hole an "accounting inaccuracy," St. Francis disclosed that its finance chief had been "permanently relieved of his duties'' in November, according to the AJC. CEO Robert Granger resigned in early March, the source stated.

The financial issue is not expected to derail a potential acquisition by Tennessee-based LifePoint Health, according to AJC. The organizations have entered into a non-binding letter of intent, according to information published Aug. 4 on LifePoint's website.

Twitter: @SusanMorseHFN