Hospitals

The hospital corporation, HCA, Inc. (formerly Columbia/HCA Healthcare Corporation), reached a $4 million settlement with the Department of Justice arising from a lawsuit brought by Getnick & Getnick LLP on behalf of a former hospital reimbursement manager alleging that HCA submitted claims to Medicare for a biological product whose safety and effectiveness had not been established and was not reimbursable. The settlement was part of a $631 million settlement with HCA. The government’s investigation into HCA involved more than 25 qui tam lawsuits, most of which were not pursued by the Department of Justice. G&G’s client was one of eight whistleblowers whose cases were joined by the Department of Justice in reaching the settlement.

Curative Health Services, Inc., which operated wound care centers in HCA and other hospitals nationwide, agreed to pay $16.5 million to settle allegations that it caused the hospitals to submit fraudulent cost reports to the government. The settlement resulted from qui tam lawsuits filed by Getnick & Getnick LLP in cooperation with a Florida law firm on behalf of two whistleblowers, one a former hospital Chief Financial Officer and the other a former hospital reimbursement manager. The whistleblowers received 19.5% of the recovery.

The national hospital chain Tenet Healthcare paid $175,000 to settle allegations that it falsely billed three times the legitimate charges for outpatient surgical pathology procedures. Although a small dollar recovery, this case, which was brought by Getnick & Getnick LLP on behalf of a Florida retiree who noticed the multiple billing on his own medical bills, exposed Tenet’s non-compliance with a government-imposed Corporate Integrity Agreement and put a stop to the overbilling of Medicare beneficiary co-payments and private-pay patients. The whistleblower received 21% of the recovery.