Topics
More on Compliance & Legal

Missouri Hospitals will pay $34 million to settle allegations of improper payments to oncologists, DOJ says

Settlement resolves allegations the providers submitted fraudulent Medicare claims for chemotherapy services through illegal referrals, DOJ says.

Beth Jones Sanborn, Managing Editor

Photo courtesy Mercy

Two Southwest Missouri providers, Mercy Hospital Springfield and its affiliate, Mercy Clinic Springfield Communities, will pay the United States $34,000,000 as part of a settlement over allegations they violated the False Claims Act through improper financial relationships with referring physicians, the Department of Justice announced.

The defendants operate a hospital, clinic, and infusion center in Springfield, Missouri, among other facilities.

The settlement resolves allegations that the defendants submitted fraudulent Medicare claims for chemotherapy services for patients referred by oncologists whose compensation "improperly took into account the value of their referrals of patients to the infusion center," which was operated by the defendants, the DOJ said.

[Also: Running list of notable 2017 healthcare frauds]

A whistleblower, or qui tam, lawsuit had been filed by Viran Roger Holden, a physician employed by one of the Defendants.  Under the False Claims Act, private citizens who bring suit on behalf of the government for false claims can share in any recovery.  AS such, Holden will receive $5,440,000.

The claims settled in the agreement are only allegations; there has been no determination of liability.

Twitter: @BethJSanborn