By RANDALL CHASE (Associated Press)
DOVER, Del. (AP) — Delaware’s largest hospital system will pay more than $47 million to settle whistleblower allegations by its former compliance officer that it provided kickbacks to outside doctors in return for patient referrals, resulting in fraudulent Medicaid billing.
The settlement announced Friday comes nearly seven years after Ronald Sherman filed his whistleblower lawsuit, which remained under seal for more than a year, against Christiana Care Health System.
The lawsuit alleged that Christiana Care employees, including nurse practitioners, hospitalists and physician assistants, treated patients referred by non-CHSS physicians at no cost or below fair market value.
Those outside physicians then billed insurers, primarily Medicaid, for care that was actually provided by Christiana employees.
In exchange for the unearned billings, the physicians continued to funnel patients to Christiana Care rather than to other hospitals, according to the lawsuit.
The alleged fraud occurred between April 2011 and September 2013 involving Christiana’s neonatology department, and between April 2011 and April 2017 invoving the cardiovascular surgery, urology, neurosurgery and ear, nose and throat departments.
State and federal authorities said the scheme violated anti-kickback laws and state and federal false claims statutes.
Attorneys for Sherman said the case is believed to be the largest False Claims Act settlement in Delaware history and...
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