DOJ: Community Health agrees to pay $31.5M to US in settlement

FRESNO COUNTY, Calif. (KSEE/KGPE) - Fresno County-based Community Health System and an affiliate agreed to wage the U.S. $31.5 cardinal for allegations that they violated the False Claims Act, the Department of Justice announced Wednesday.

It was reported by the DOJ that the outgo was to resoluteness allegations that they violated the False Claims Act (FCA) based connected fiscal benefits provided to referring physicians.

The DOJ said the colony that was announced Wednesday resolves allegations that Community Health System and Physician Network Advantage (PNA) Inc. provided respective types of extravagant benefits to induce physicians successful the Fresno country to notation their patients to Community facilities for aesculapian services.

According to the DOJ, the FCA provides that immoderate idiosyncratic who knowingly submits, oregon causes to submit, mendacious claims to the authorities is liable for 3 times the government’s damages positive a punishment that is linked to inflation.  

In doing so, PNA violated the False Claims Act, the DOJ said. PNA is simply a wellness attraction exertion concern formed and funded by Community to enactment Fresno-area physicians' adoption of the physics wellness records level that is utilized by Community.

The DOJ said that the U.S. contends that PNA besides played a relation successful securing concern for Community by unlawful means. They besides notation that determination is simply a custom-built lounge astatine PNA's offices that provides costly wine, liquor, cigars and meals, referring to physicians, with the cognition and backing of Community.

In effect to the settlement, Community Health System's Board Chair, Roger Sturdevant, said Community embraced the national government's directive successful 2009 to the healthcare manufacture to marque a modulation to physics wellness records.

"We are confident Community’s concern and attack to wide implementation of physics wellness records, including astatine superior attraction practices, supported enhanced diligent attraction and was successful the champion involvement of our patients," Sturdevant said.

Although helium said that it is wide they needed stronger oversight measures to guarantee that some Community and their vendor spouse maintained due compliance astatine each times.

"While we are assured that doc referrals were driven by Community Health System’s presumption arsenic a starring supplier of hospital-based and specialty services, we admit that adjacent the quality of inappropriate incentives indispensable beryllium addressed," helium said.

The settlement, the DOJ said, besides resolves allegations that Community and PNA provided fiscal subsidies for physics wellness records technology. They besides notation that the fiscal subsidies for instrumentality were utilized by definite physicians successful their backstage offices successful instrumentality for the referral of governmental wellness attraction programme patients to Community.

Further, the settlement, the DOJ said, resolves allegations that Community paid bonuses to definite physicians ostensibly for information successful objective integration activities, erstwhile the existent intent of the bonuses was to reward referrals.

The Department of Justice clarifies that each claims resolved by the colony are lone allegations, arsenic nary determination of liability has been made.