Dive Brief:
- Westchester Medeical Center in New York has agreed to pay $18.8 million to settle a lawsuit claiming it violated a federal anti-kickback law and defrauded Medicare.
- The suit alleged that the hospital paid a local cardiology practice for referrals and obtained fraudulent Medicare resimbursements.
- The hospital was facing allegations of federal False Claims Act violations between 2000 and 2007.
Dive Insight:
The case was originally filed by Dan Brisk, the hospital's former compliance officer, in 2006. Under the federal False Claims Act, whistleblowers can file claims on behalf of the government and share in the proceeds from recovery. Although Brisk died before the case was resolved, his widow continued to pursue it on his behalf.
The hospital said in a statement, "Although the Medical Center believes that its financial relationships with its clinical faculty are customary for academic medical centers of its size and complexity, we acknowledge that, with respect to a very small number of legacy relationships, we could not produce documentation sufficient to meet certain technical requirements of federal law."
Whistleblower cases appear to be on the rise. In order to beat these cases, hospitals need to not only make sure they're not in violation of federal laws, but also that they have the necessary documentation to prove they are meeting federal requirements.