The Justice Department recently announced a $846,461 settlement by a Minnesota critical access hospital and one of its physician’s to settle False Claims Act allegations. A former doctor at the critical access hospital filed a qui tam (“whistleblower”) action alleging that the physician admitted patients that did not need to be admitted, or kept other patients in acute care when doing so was not medically necessary, and ordered unnecessary testing. The whistleblower contended that he complained to the hospital about the physician’s alleged practices, but that the hospital did nothing. The government investigated the allegations, reviewing nearly 200 of the physician’s patient admissions. Several admissions were identified as not medically necessary under Medicare rules. Additionally, the investigation revealed that the physician generated more than $4 million a year in billings for the hospital, which is 10 times that of its other doctors. You may read the DOJ’s press release here.
von Briesen Health Law Blog
