Dr. Deborah Hauger witnessed illegal kickbacks at Fort Hamilton Hospital in Cincinnati and refused to turn a blind eye, filing a qui tam lawsuit against her former employer Health Alliance of Greater Cincinnati, the owner of Fort Hamilton. More often than not, physicians are unwilling to levy such allegations of fraud even when they see it everyday for fear that they will jeopardize their hard-won, lucrative careers. Hauger — a cardiologist — proves, however, that the ethical thing to do can also reap financial rewards. Today, DoJ announced that Health Alliance of Greater Cincinnati, Fort Hamilton Hospital, The University Hospital, and University Internal Medicine Associates Inc. will pay Hauger nearly half a million dollars out of a $2.6 million settlement. According to DoJ, Hauger’s qui tam suit centered upon a physican group offering its services in exchange for referrals:
The alleged scheme involved the hospital’s desire to expand the scope of its cardiology services to include certain interventional cardiology procedures. Under state law, The Fort Hamilton Hospital could only perform the interventional cardiology procedures if it participated in a particular clinical trial involving those procedures.
University Internal Medicine Associates, a physician group based at The University Hospital in Cincinnati, offered to provide the interventional cardiology coverage that The Fort Hamilton Hospital needed for the clinical trial, but only if the hospital agreed to refer cardiology patients and procedures to the physician group on a preferential basis.
The federal False Claims Act is arguably the best tool for uncovering violations of the federal Anti-Kickback Statute, an enforcement priority for DoJ. According to Tony West, Assistant Attorney General for the Civil Division, the Justice Department is “committed to protecting the integrity of our federal health care programs by ensuring that financial incentives do not improperly interfere with patient choice and the exercise of sound medical judgment.”
To report illegal kickback arrangements or other Medicare fraud, contact Frohsin & Barger.
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