"Cheating refers to an immoral way of achieving a goal. It is generally used for the breaking of rules to gain unfair advantage in a competitive situation." (DICTIONARY), THE CRBCM IS A VICTIM ALL THE TIME, LIVING WITH IT, UNTIL THE ENEMIES CEASE AND DESIST OR OTHERWISE BECOME IRRELEVANT! THE FBI IS WATCHING!
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Physician-Owned Hospital Agrees to Resolve its Civil and Criminal Liability for Benefiting from Illegal Kickbacks to Physicians
FOR IMMEDIATE RELEASE (http://www.justice.gov/usao/ txn/PressRelease/2013/SEP2013/ sep12FPMC_sett.html)
September 12, 2013
DALLAS
- Forest Park Medical Center, LLC (FPMC), a North Texas physician-owned
hospital, paid over $258,000 to settle allegations that it violated the
civil False Claims Act, announced U.S. Attorney Sarah R. Saldaña of the
Northern District of Texas. The United States contends that a FPMC
representative paid illegal kickbacks to area physicians to obtain
referrals for Tricare patients, a federally funded health care program,
in violation of the federal law, between 2008 and 2012. Based on the
same allegations, FPMC entered into a Non-Prosecution Agreement with the
United States and agreed to certain conditions, as well as a federally
imposed monitor for not more than 24 months. FPMC fully cooperated with
the investigation, and by settling civilly and criminally, did not
admit any wrong-doing or liability.
FPMC,
located in Dallas, did not seek reimbursement from any federal sources
such as Medicare and Medicaid, but only commercial payors and self-pay.
Federal and State law usually limits the amount of compensation paid to
physicians and their ability to refer certain patients under
federally-insured programs. Because FPMC believed it did not accept
federal funds, its representatives, to the benefit of FPMC’s behalf,
offered and paid excessive remuneration and other things of value to
actual and potential referring physicians or others, including amounts
for “marketing” or “advertising.” Payments also were made in the form
of cash and giftcards/coupons for luxury items. The United States
alleges such payments were made to obtain federal health care program
patients, such as TRICARE, a program for military retirees and their
dependents. The United States contends such payments were unlawful
kickbacks for the referral of federal health care program patients in
violation of the federal Anti-Kickback Statute between January 1, 2008,
and October 31, 2012. The United States initiated the investigation in
response to numerous complaints.
In
the Non-Prosecution Agreement, FPMC acknowledged the United States has
sufficient evidence to seek an indictment for the offering and payment
of illegal kickbacks in violation of federal law. In return for the
non-prosecution of the hospital, FPMC selected and retained an
independent monitor to address any compliance issues and the United
States’ concerns regarding the allegations of illegal conduct. The
monitor will be in place for not more than 24 months and will review and
evaluate inpatient and outpatient claims submitted to all payors, not
just federal programs. FPMC also agreed to cooperate with the United
States’ ongoing investigation into certain individuals. No persons were
released under the civil and criminal agreements. The United States’
investigation remains ongoing.
U.S.
Attorney Saldaña praised the efforts of the investigating agencies,
including the Defense Criminal Investigative Services; FBI; Department
of Labor, EBSA; Office of Inspector General of the Office of Personnel
Management; and FDA-CI.
“This
civil and criminal resolution spares the honest employees and investors
of FPMC, while holding the hospital accountable for allowing an
environment where its representatives paid illegal kickbacks for
referrals,” said U.S. Attorney Saldaña. “This outcome imposes
well-deserved measures that we expect will ensure FPMC becomes fully
compliant with federal and private health care program requirements.
Whether physician-owned, not-for-profit or for-profit, the Department of
Justice expects, and requires, all providers to be trustworthy and
abide by the law,” Saldaña continued.
The
case was handled by Assistant U.S. Attorneys Sean McKenna, Errin Martin
and Lynette Wilson, and Special Assistant U.S. Attorney Glenn Harrison.