A federal judge ordered South Carolina’s Tuomey Healthcare System to pay $277 million for violating laws that bar hospitals from paying doctors to refer Medicare patients for treatments. The ruling – a result of the denial of Tuomey’s post-trial motions and the granting of the government’s request to impose Stark Penalties and False Claims Act fines – is believed to be the largest of its kind against a community hospital in U.S.
In a ruling meant in part to keep the government from benefitting from its “apathetic conduct”, a New Mexico federal judge upheld a magistrate judge’s recommendation for sanctions against the government for failing to safeguard documents that may have aided Community Health Systems (CHS) in defending against a whistleblowers Medicaid claim.
Two years after the opening of the SEC’s whistleblower office, Division Head Sean McKessy provides an interview outlining the success of the program as well as the future direction of the program. In 2012 alone, the SEC received 3,001 whistleblower tips.
The United States announced a new program in cooperation with the Swiss government that allows Swiss banks not currently under criminal investigation to be eligible for non-prosecution agreements in exchange for their cooperation in investigating offshore tax evasion schemes.
The IRS recently named John Dalrymple as the new Deputy Commissioner for Services and Enforcement. In that role Dalrymple will oversee four IRS operating divisions including Wage and Investment, Large Business & International, Small Business/Self-Employed and Tax Exempt and Government Entities.
A recent article in the New York Times discloses how an IV bag of saline solution, which costs at most $1 to manufacture, ends up costing hospital patients hundreds of dollars. In “How to Charge $546 for Six Liters of Saltwater,” the author details charges to a group of individuals treated for food poisoning in upstate New York.
Imagimed, LLC and several of its former owners and staff physicians settled allegations of false claims with the US Attorney for the Northern District of New York. The false claims concerned Imagimed’s fraudulent practice of performing MRI’s with contrast dyes without direct supervision of a qualified physician. A physician is required to be present because of the risk of anaphylactic shock.
The SEC Whistleblower program has yet to land a big FCPA case. SEC Whistleblower Head Sean McKessy predicts that FCPA claims will materialize and believes the number of FCPA tips reported may be higher than noted. Nonetheless, others are skeptical about whether the FCPA is a viable avenue for SEC whistleblowers.
ATI Enterprises, Inc. agreed to pay the government $3.7 million to settled claims that it falsely certified compliance with federal financial aid programs. The government claims that ATI fraudulently misrepresented its job placement statistics to maintain its eligibility for financial aid programs, and that it fraudulently induced students to enroll in the school and to maintain their enrollment to increase the amount of federal dollars received.
Terry Myers tried in vain to have Shands Hospitals self report improper billing practices his company found during routine audits over several years. The improper billing concerned Shands practice of routinely admitting Medicare and Medicaid patients who were not sick enough to need inpatient care.
