• Christ Hospital of Cincinnati Settles FCA Whistleblower Suit After Seven Years
  • March 2, 2010 | Author: Keasha Ann "Ann" Broussard
  • Law Firm: King & Spalding LLP - Atlanta Office
  • The Christ Hospital of Cincinnati and the Health Alliance of Greater Cincinnati reached a settlement in principle with the U.S. Department of Justice last week, almost seven years after they were first accused of violating the False Claims Act’. See United States ex rel. Fry v. Health Alliance of Greater Cincinnati, No. C-1-03-167 (S.D. Ohio), dismissed Feb. 2, 2010. The financial terms of the settlement have not yet been disclosed. The alleged improper conduct was that the hospital gave preferential treatment to certain physicians in scheduling time for the hospital’s outpatient heart testing unit based on the number of referrals generated to the hospital.

    Cardiologist Dr. Harry Fry originally brought the lawsuit against the hospital in a qui tam action, alleging that between 1999 and 2004 Christ Hospital allotted time in an outpatient testing unit known as the Heart Station based solely on the number of coronary artery bypass graft (CABG) procedures or “cath-lab” revenues they or their group generated for Christ Hospital during the previous year.

    An April 2008 press release from the Department of Justice stated, “Federal law makes it unlawful to provide or receive financial incentives in exchange for patient referrals. In this case, cardiologists ¿ were rewarded for referring business or generating revenue for Christ Hospital with the opportunity to bill for the patients they treated at the Heart Station and for any follow-up procedures that these patients required. This system for scheduling time at the Heart Station gave area cardiologists an incentive to perform certain cardiac procedures at Christ Hospital and prevented otherwise-qualified cardiologists, who failed to generate income for Christ Hospital during the previous year, from working at the Heart Station.”

    Christ Hospital, in a statement denying any wrongdoing, said the settlement “allows the hospital to avoid the risk of the multi-billion award sought by the government.” In 2008, the U.S. Attorney’s Office for the Southern District of Ohio in Cincinnati originally indicated that the government sought a judgment against the hospital equal to three times the amount of actual damages sustained by Medicaid and Medicare from 1999 to 2004, plus statutory penalties of up to $11,000 for each violation, counting an estimated 100,000 violations.

    The hospital and its doctors have insisted that many of the procedures billed to Medicare and Medicaid were for necessary and relatively low-cost procedures like electrocardiograms and that merely assigning outpatient clinic time at the Heart Station did not in fact induce cardiologists to refer patients to Christ Hospital for more costly inpatient procedures.