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Beaumont Hospital Corporate Integrity Agreement

12 September 2021 No Comment

William Beaumont Hospital, a regional hospital system based in Detroit, Michigan, will pay US$84.5 million to clarify false Claims Act allegations about inappropriate relationships with eight transferring physicians, resulting in false claims being filed with the Medicare, Medicaid and TRICARE programs, the Department of Justice announced today. Dentons US LLP will conduct a more comprehensive review of the complaints, the settlement agreement, the CIA and all other relevant documents as soon as they become available, and intends to prepare a follow-up warning in the near future. Beaumont Health has agreed to pay a $US 84.5 million deal to the U.S. Department of Justice, the state of Michigan and four whistleblowers for violating federal laws preventing hospitals from overpaying doctors and filing false allegations. These cases illustrate the challenges faced by rural hospitals in terms of care for local residents. As Kaiser Health News reported, a spokesman for Wheeling Hospital, which responded to the DOJ`s complaint, commented that “we are confident that. There will be no evidence of misconduct – just evidence that Wheeling Hospital will. [local] Have access to top-notch care, first-class physicians and services. However, with the DOJ`s increased scrutiny of specialist compensation envelopes, hospitals may have to look for strategies other than simply participating in bidding wars to recruit and retain doctors. The DOJ argued that the defendant had awarded the adjectors significantly more than fair value (FMV) compensation in the form of vacant office space or FMV, as well as the use of hospital staff to assist doctors` offices in obtaining referrals from physicians. The DOJ also claimed that the claims filed by the hospital for services provided to illegally transferred patients were contrary to the ACF.

Interestingly, the allegations arising from this transaction stem from four separate whistleblower complaints and relate to allegations of conduct between 2004 and 2012. This timeframe indicates that healthcare providers may still face significant potential liability for non-conforming behaviours long after the underlying behaviour. In addition to the payment of money, the defendant agreed to enter into a five-year business investment agreement (CIA) with the Office of Inspector General (OIG). “Providing physicians with financial incentives in return for patient transfers undermines the integrity of our health care system,” said Assistant Attorney General Chad A. Readler of the Justice Department`s Civil Department. “Patients deserve the full and independent judgment of their healthcare professionals.” Fox said there were no complaints “about the quality of care provided to patients by a doctor in one of the three hospitals” that were part of Beaumont`s former health care system. These hospitals include the Flagship Hospital at Royal Oak and those at Grosse Pointe and Troy. As part of the transaction, Beaumont will also enter into a five-year corporate integrity agreement with the U.S. Department of Health.

The transaction agreement also asserts that WBH provided and billed certain CT radiology services as hospital services, although the imaging center did not meet regulatory requirements based on Medicare providers. . . .

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Kathy Becker (319 Posts)

Kathy is the CEO/President of the Company of Experts, Inc. and oversees this Small Woman Owned Business serving schools, colleges and universities, businesses, corporations and non-profits moving them from deficit models of planning and thinking to engagement, empowerment and collaboration.

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