Michigan Hospital System Pays $84.5 Million for Alleged Billing of Kickback-Induced Services
Case: William Beaumont Hospital has agreed to cough up $84.5 million to settle False Claims Act charges. The case, which began as a qui tam whistleblower lawsuit, contends that the Detroit-based regional hospital system provided free or below-market office and employment assistance to eight physicians in exchange for referrals of lab and other services between 2004 and 2012. Significance: Paying kickbacks to referring physicians was the primary offense (although the feds also claim that Beaumont misrepresented that its CT radiology center qualified as an outpatient department in its billings). So, it may seem odd that was this an FCA rather than an Anti-Kickback case. The explanation is simple: Beaumont brought the FCA—and its more punitive provisions—into play by subsequently billing the services generated by the allegedly ill-gotten referrals to Medicare, Medicaid and TRICARE.
Case: William Beaumont Hospital has agreed to cough up $84.5 million to settle False Claims Act charges. The case, which began as a qui tam whistleblower lawsuit, contends that the Detroit-based regional hospital system provided free or below-market office and employment assistance to eight physicians in exchange for referrals of lab and other services between 2004 and 2012.
Significance: Paying kickbacks to referring physicians was the primary offense (although the feds also claim that Beaumont misrepresented that its CT radiology center qualified as an outpatient department in its billings). So, it may seem odd that was this an FCA rather than an Anti-Kickback case. The explanation is simple: Beaumont brought the FCA—and its more punitive provisions—into play by subsequently billing the services generated by the allegedly ill-gotten referrals to Medicare, Medicaid and TRICARE.
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