Texas-Based Heart Hospital Agrees to $48M Settlement for Violating Anti-Kickback Statutes
On December 18, Texas Heart Hospital of the Southwest LLP and its subsidiary THHBP Management Company, LLC (collectively THH) agreed to pay a settlement of $48 million to the U.S. government for knowingly submitting false claims through the Medicare program that allegedly violated the Anti-Kickback Statute. According to a U.S. Department of Justice (DOJ) press release, the qui tam lawsuit was brought by two whistleblowers who were former physicians and partial owners of THH. The government alleges that THH illegally required physicians to contact or refer 48 patients a year in order to keep their partial ownership of THH. A contract that requires or incentivizes physicians to bring in or keep a quota of patients to a hospital would violate the Stark Act and the Anti-Kickback Statutes of the False Claims Act.
The DOJ claims that THH contractually required inappropriate relationships between physicians and the hospital by connecting patient contacts with financial incentives. Acting Assistant Attorney General Jeffrey Bossert Clark stated in the press release that “Inappropriate financial relationships between health care providers and their referral sources can distort physician decision-making and drive up health care costs for everybody.” The DOJ has recently announced a number of other settlements involving inappropriate physician/hospital relationships revealed by whistleblower lawsuits similar to this one, including the Doctor’s Choice Home Care settlement, the Merit Medical Systems settlement, and the Wheeling Hospital kickback settlement. Each of these lawsuits was uncovered by whistleblowers and alleged the existence of large kickback or illicit remuneration programs.
