Adventist Health Settles False Claims Charges for $14M; Whistleblowers to Get $2.8M
Adventist Health and its Los Angeles-based affiliated hospital White Memorial Medical Center have agreed to pay the United States and the State of California $14.1 million to settle allegations that they violated the Anti-Kickback Act, the Stark Statute, and the False Claims Act, the U.S. Department of Justice announced last week.
Adventist Health allegedly improperly compensated physicians who referred patients to the White Memorial facility by transferring assets, including medical and non-medical supplies and inventory, at less than fair market value. Referring physicians also allegedly received compensation at above fair market value for providing teaching services at White Memorial’s family practice residency program. The United States alleged that these payments violated the Anti-Kickback Act and Stark Statute, and by extension, the False Claims Act. The Anti-Kickback Act prohibits offering, paying, soliciting or receiving remuneration to induce referrals of items or services covered by Medicare, Medicaid and/or other federally-funded programs. The Stark Statute prohibits a hospital from submitting claims for patient referrals made by a physician with whom the hospital has an improper financial arrangement. By extension, White Memorial Medical Center violated the False Claims Act when it knowingly caused the submission of false claims to Medicare and/or Medicaid for patients who were referred to the hospital because of the kickbacks and not legitimate patient need.
As part of the settlement, White Memorial has entered into a comprehensive five-year Corporate Integrity Agreement with the Office of Inspector General of the U.S. Department of Health and Human Services to ensure its continued compliance with federal health care benefit program requirements.
The lawsuit was originally filed by Dr. Hector Luque and Dr. Alejandro Gonzalez under the qui tam, or whistleblower, provisions of the False Claims Act. The False Claims Act allows private citizens with knowledge of fraud to sue on behalf of the United States and share in a portion of the recovery. Luque and Gonzalez will receive approximately $2.8 million as their share of the recovery in this case.
The Chanler Group, in association with the Hirst Law Group, represents whistleblowers who take action under the False Claims Act to report fraud committed against the federal and state governments. We have years of experience representing whistleblower clients who expose every kind of fraud against the government, including health care fraud, contract fraud, and tax fraud. Read more about our expertise in False Claims Act cases and how you can take action.