Dive Brief:
- One of the administrative divisions of South Shore Hospital (Boston) is paying $1.8 million in civil penalties after state and federal investigators found the organization guilty of an illegal kickback scheme. The suit alleged that the South Shore division paid doctors to refer patients to services within the hospital's healthcare network. The group, South Shore Physician Hospital Organization, which does contracting and administrative work for South Shore Hospital and its affiliated doctors, denies wrongdoing.
- The kickbacks included 103 payouts to 33 physician groups over nine years ending in 2010, according to authorities.
- However, Matthew Whalen, the executive director of South Shore Physician Hospital Organization, said patients benefited from the program by gaining access to high-quality physicians.
Dive Insight:
While Whalen may be on point in his statements that patients benefited from seeing physicians within the Shore Physician Hospital Organization, whether patients received excellent care is not the issue in question here. The concern is that independent physicians groups affiliated with South Shore Hospital received cash incentives for keeping treatments within South Shore’s system, illegal under Stark. But since the executive director brings it up, it's hard to say to what extent physicians may have been motivated for profit to care for the self-referred patients.
The case raises questions of whether doctors were working to pad their wallets or provide the best possible care for patients, analysts said.
"Beyond that the fact that it is illegal, it is clearly unethical," said Dr. Ashish Jha, a professor at Harvard School of Public Health. "We want doctors making choices based on what's best for the patient, not based on the physician's own financial well-being."