U.S. Attorney Michael DiGiacomo announced that Catholic Health System, Inc. (CHS) has agreed to pay $3,293,122.66 to settle allegations under the False Claims Act. These allegations suggest CHS knowingly submitted false claims to Medicare due to violations of the Physician Self-Referral Law, known as the Stark Law.
The Stark Law generally prohibits healthcare entities from seeking Medicare reimbursement for services referred by physicians with financial ties to those entities. It is alleged that CHS and its affiliated hospitals maintained financial relationships with non-employee physicians who referred services like laboratory testing and medical supplies back to them. The government believes these compensation arrangements did not meet any legal exceptions as they were not commercially reasonable or exceeded fair market value.
“The Stark Law is designed to protect Medicare by ensuring that physician referrals are not influenced by financial interest,” said U.S. Attorney DiGiacomo. “This office is committed to holding health care providers accountable who engage in such conduct.”
The settlement resolves claims brought under the whistleblower provisions of the False Claims Act by Gary Tucker. Under these provisions, individuals can file actions on behalf of the United States and receive a portion of any recovery obtained. Tucker will receive a share of this settlement.
Assistant U.S. Attorney David M. Coriell and Investigator Margaret McFarland from the United States Attorney’s Office for the Western District of New York handled this matter with help from the Department of Health and Human Services' Office of Inspector General.
It should be noted that these resolved claims are merely allegations and there has been no determination of liability.
