SAGINAW, Mich. (WNEM) - Covenant Healthcare System and two physicians paid over $69 million to resolve allegations under the False Claims Act of improper financial relationships.
United States Attorney Dawn N. Ison made the announcement on Monday, April 3, stating that the allegations were made against eight referring physicians and a physician-owned investment group, which resulted in the submission of false claims to the Medicare, Medicaid, TRICARE, and FECA programs.
The Anti-Kickback Statute (“AKS”) prohibits offering, paying, soliciting, or receiving remuneration to induce referrals of items or services covered by Medicare, Medicaid, and other federally-funded programs.
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 an improper financial arrangement, including the payment of compensation that exceeds the fair market value of the services actually provided by the physician and the provision of free or below-market rent.
AKS and the Stark Law are intended to ensure that physicians’ medical judgments are not compromised by improper financial incentives, and that they are based on the best interests of their patients.
The settlement with Covenant resolves the following allegations:
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