California hospital pays more than $3.2 million to settle allegations
A hospital in Oceanside, Calif., agreed to pay more than $3.2 million to settle claims it violated laws and Medicare’s prohibition on having an illegal financial relationship with referring physicians.
The federal government alleged that Tri-City Medical Center had 97 financial arrangements with physicians and physician groups that were not in compliance with the Stark Law, according to a news release.
Of the financial arrangements, five were with the hospital’s former chief of staff and 92 were with community-based physicians and practice groups.
“The claims settled by this agreement are allegations only, and there has been no determination of liability,” the Department of Justice wrote in the release.
Under the Stark Law, hospitals are typically not allowed to bill Medicare for services referred by physicians who have a financial relationship with the hospital. There are some exceptions to the rule, and hospitals and physicians must prove the financial arrangements do not exceed fair market value, among other considerations.
“Patient referrals should be based on a physician’s medical judgment and a patient’s medical needs, not on a physician’s financial interests or a hospital’s business goals,” U. S. Attorney Laura E. Duffy of the Southern District of California said in a news release. “This settlement reinforces that hospitals will face consequences when they enter into financial arrangements with physicians that do not comply with the law. We will continue to hold health care providers accountable when they shirk their legal responsibilities to the detriment of tax payer-funded health care programs.”
Executive Editor
Tim Casey joined TriMed Media Group in 2015 as Executive Editor. For the previous four years, he worked as an editor and writer for HMP Communications, primarily focused on covering managed care issues and reporting from medical and health care conferences. He was also a staff reporter at the Sacramento Bee for more than four years covering professional, college and high school sports. He earned his undergraduate degree in psychology from the University of Notre Dame and his MBA degree from Georgetown University.