Health Alliance of Greater Cincinnati, Two Member Hospitals, Physician Group, to Pay $2.6 Million to Resolve Whistleblower Fraud Claims
The Health Alliance of Greater Cincinnati, two member hospitals, and an affiliated physician group will pay the federal government $2.6 million to settle alleged kickback-for-referral allegations, the Department of Justice announced.
Named with The Health Alliance in the whistleblower settlement were The Fort Hamilton Hospital, The University Hospital, and physicians' group University Internal Medicine Associates Inc.
It's the second time in less than one month that the Health Alliance has been involved in a multimillion dollar whistleblower settlement with DOJ. On May 24, Health Alliance and former affiliate The Christ Hospital agreed to pay $108 million to settle similar allegations.
Federal prosecutors said the alleged scheme at 310-bed The Fort Hamilton (OH) Hospital was fueled by the hospital's desire to expand its cardiology services to include interventional procedures that state law prohibited at that hospital unless they were part of a clinical trial. University Internal Medicine Associates, based at The University Hospital in Cincinnati, allegedly offered to provide the interventional cardiology coverage that The Fort Hamilton Hospital needed for the clinical trial, but only if the hospital agreed to preferential referrals of cardiology patients and procedures to the physician group, prosecutors said.
That arrangement resulted in patients being transferred to The University Hospital, or being seen by cardiologists with University Internal Medicine Associates rather than the hospital or cardiologist of their choosing, a violation of the federal anti-kickback statute. The False Claims Act violations were allegedly committed when the two hospitals and the physicians group submitted claims generated by the illegal scheme to Medicare, prosecutors said.
The Hospital Alliance did not return requests seeking comment.
The suit was initiated by whistleblower Deborah Hauger, MD, a cardiologist who formerly worked at The Fort Hamilton Hospital. She will receive $468,000.
John Commins is a senior editor with HealthLeaders Media.
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