|DoJ assists whistleblower in suit against three providers. Source: Personnel Today|
The Department of Justice (DoJ) has filed a $140 million civil fraud complaint, seeking damages from Christ Hospital, the Health Alliance of Greater Cincinnati, Ohio Heart and Vascular Center and the now shuttered Medical Diagnostic Associates, for an alleged kickback scheme.
According to the charges, Ohio Heart and Christ Hospital traded referrals for patients whose services were billed to Medicare and other federal programs.
The DoJ first intervened in the whistleblower suit in April, alleging that Christ Hospital and Ohio Heart, the largest cardiology group in Greater Cincinnati, “devised a scheme that provided cardiologists with improper financial incentives in exchange for generating revenue for the hospital.”
The suit claims that the entities “improperly rewarded” doctors for referring patients or generating revenue for Christ Hospital and the alliance from 1997 to 2004.
Tony Condia, a spokesman for Health Alliance, told the Cincinnati Enquirer that executives for the healthcare network had no knowledge of the arrangement between Christ Hospital and Ohio Heart. “We believe we have no liability in this case,” he said.
Due to the government’s involvement, the charges could eventually top $420 million.
The federal complaint filed on July 29 stems from a whistleblower lawsuit initially filed in 2003 by cardiologist Harry Fry, which was sealed until the government joined the suit.
The complaint claims that, from 1999 to 2004, Christ Hospital awarded time in its diagnostic center to cardiologists based on how much business they sent to the hospital for surgical procedures, including coronary artery bypass surgeries.
Thousands of patients and procedures were allegedly involved, according to the Cincinnati Enquirer. One patient referred to a physician for a diagnostic procedure could ultimately generate up to $200,000 in revenue for the hospital, the suit claims.