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Missouri Hospitals to pay U.S. $34m to settle alleged false claims

Staff Writer |
Two Southwest Missouri health care providers have agreed to pay the United States $34,000,000 to settle allegations that they violated the False Claims Act by engaging in improper financial relationships with referring physicians, the Justice Department announced.

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The two Defendants are Mercy Hospital Springfield f/k/a St. John’s Regional Health Center, and its affiliate, Mercy Clinic Springfield Communities f/k/a St. John’s Clinic. Among other health care facilities, the Defendants operate a hospital, clinic, and infusion center in Springfield, Missouri.

The settlement announced today resolved allegations that the Defendants submitted false claims to the Medicare Program for chemotherapy services rendered to patients referred by oncologists whose compensation was based in part on a formula that improperly took into account the value of their referrals of patients to the infusion center operated by the Defendants.

Federal law restricts the financial relationships that hospitals and clinics may have with doctors who refer patients to them.

The allegations settled arose from a lawsuit filed by a whistleblower, Dr. Viran Roger Holden, a physician who was employed by one of the Defendants, under the qui tam provisions of the False Claims Act.

Under the act, private citizens can bring suit on behalf of the government for false claims and share in any recovery. Dr. Holden will receive $5,440,000 from the recovery.

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