Source: United States Department of Justice News
Sibley Hospital (Sibley) and its parent company, Johns Hopkins Health System (Johns Hopkins), have agreed to pay the United States $5 million to resolve allegations arising from claims that Sibley submitted to the Medicare Program, the Justice Department announced today.
The Physician Self-Referral Law, commonly known as the Stark Law, prohibits a hospital from billing Medicare for certain services referred by physicians with whom the hospital has a financial relationship, unless that relationship satisfies one of the law’s statutory or regulatory exceptions. It is intended to ensure that medical decision-making is not influenced by improper financial incentives and instead is based on the best interests of the patient.
Today’s settlement resolves allegations that, from 2008 through 2011, Sibley violated the Stark Law by billing Medicare for services referred by ten cardiologists to whom Sibley was paying compensation that exceeded the fair market value of the services provided. These allegations arose out of conduct that Sibley and Johns Hopkins self-disclosed to the United States.
“Improper financial arrangements between hospitals and physicians can influence the type and amount of health care that is provided,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “The department is committed to holding accountable those who violate prohibitions designed to protect the integrity of physician decision-making.”
“Patients have the right to medical care that is strictly about their health and not about the financial benefit or obligation that a physician might receive or owe,” said U.S. Attorney Graves for the District of Columbia. “We welcome conversations with anyone who might have credible information that medical care is being undermined by outside influences. This office works in concert with many partners to protect the public, including the Fraud Section of the Department of Justice and the Office of Inspector General for the U.S. Department of Health, to ensure the rules are followed.”
The resolution obtained in this matter was the result of a coordinated effort between the Civil Division’s Commercial Litigation Branch (Fraud Section), the U.S. Attorney’s Office for the District of Columbia and the Office of Inspector General for the Department of Health and Human Services.
This matter was handled by Fraud Section Attorney David Wiseman and Assistant U.S. Attorney Heather Graham-Oliver for the District of Columbia.
The claims resolved by the settlement are allegations only and there has been no determination of liability.