Optim Healthcare, Tattnall hospital settle whistleblower suit with government, Schaengold
|By Jan Skutch, Savannah Morning News, Ga.|
|McClatchy-Tribune Information Services|
The order, which was dated Wednesday, unsealed the 2011 complaint. It stated that
The order said Moore found "the terms of the settlement to be appropriate in light of the facts of this case" but did not discuss the agreement's provisions at length.
The settlement concludes the action filed under court seal in 2011 by the government based on Schaengold's revelations against
Also named were
On Schaengold's motion, Scribner was dismissed from the action, Moore's order said.
"Schaengold does not object to the
settlement agreement negotiated by the government," said Moore.
He dismissed the complaint against the remaining defendants and ordered each of them to pay their own court costs and attorneys fees.
The government's investigation was initiated when it received numerous complaints that patients, who lived in the
The settlement announced Thursday resolved allegations that between 2008 and 2012,
The Stark Law is intended to ensure that a physician's medical judgment is not compromised by improper financial incentives and is based solely on the best interests of the patient.
The complaint contended the defendants unlawfully inflated charges at
Once the plan was implemented, the defendants inflated charges and overcharged patients because their deductible and co-insurance amounts were pushed up by the inflated charges in violation of the False Claims Act, the suit contended. In addition, physicians were paid referral fees in the form of excessive compensation and incentives to refer patients to the defendant facilities, the suit alleged.
According to the suit, Kleinpeter and Scribner admitted in 2009 that after buying the
"They simply chose an arbitrary inflation factor with no relationship to actual cost increases," the complaint said.
The complaint also alleged that before
According to the complaint, no medical or other legitimate reason could be found for referrals to geographically remote facilities.
Schaengold "deduced that the reason for such referrals was to generate increased patient volume at
Kleinpeter said Thursday that Optim "vehemently" disagrees with the allegations included in the complaint.
"The complaint was filed by the former chief executive officer of one of our competitors, who has no knowledge of our internal operations, and who stands to gain financially from the resolution of this matter," Kleinpeter said.
"The settlement also resolves a disagreement with the government concerning alleged billing errors," he said, "This is a national phenomenon, with more than 750 of these types of claims being filed across the country in the past fiscal year alone.
He said Optim decided to accept a settlement rather than deal with the legal fees and distraction a lengthy legal proceeding.
"This kind of behavior adversely affects both patient care and health care costs, and will not be tolerated," Jackson said.
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