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HCA pays $16.5M in Health Care Fraud

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Baisha Kreuzer5 years ago

One of the nation's largest private hospital chains has arranged to pay $16.5 million to resolve health care fraud complaints.

According to news, HCA Inc. is suspected of violating the Ethics in Patient Referrals Act (Stark Law), the False Claims Act, and other federal and state laws while operating its subsidiary, Parkridge Medical Center, Inc., in Chattanooga, TN.

Parkridge Medical Center Makes Multiple False Claims

  • From 2007-2011, HCA through Parkridge submitted claims to Medicare, TRICARE, and TennCare/Medicaid for inpatient and outpatient hospital services referred by Diagnostic physician members. These doctors benefitted from the prohibited financial arrangements.
  • The financial benefits included lease of office space from Diagnostic at a rental rate well in excess of fair market value to meet the mortgage obligations.

Whistleblower Started Claim

The investigation into the fraud began as a result of a whistleblower complaint filed in 2008. The investigative team consisted of representatives from the U.S Department of Health and Human Services – Office of Inspector General, the U.S Attorney’s Office for the Eastern District of Tennessee, and several others. The effort of the multiple agencies was commended as their investigation proved complex, yet beneficial.

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