Dive Brief:
- Daytona, Fla.-based Halifax Hospital Medical Center and Halifax Staffing have agreed to pay $85 million to resolve allegations that they violated the False Claims Act by submitting Medicare claims that violated the Stark law.
- The Department of Justice alleged that Halifax knowingly violated the Stark law by contracting with six medical oncologists in a manner that improperly included an incentive bonus for the value of prescription drugs and tests the oncologists ordered, and Halifax then billed Medicare.
- The government also alleged that Halifax knowingly violated the Stark law by paying three neurosurgeons more than fair market value for their work, and that the hospital admitted patients who didn't need admission, then billed Medicare for their care.
Dive Insight:
Avoiding violations of the Stark law and False Claims Act generally keeps health lawyers and their staffs in business. If true, the allegations against Halifax appear to be fairly straight ahead cases of FCA violations. But more often, given the complexity of the relationship between physicians and hospitals, there's some wiggle room as to whether an arrangement really does run afoul of this legislation. When it comes to false claims, hospitals must never let down their guard.