Attorney General Kathy Jennings announced Friday that Delaware’s Medicaid program would receive $7,666,379.00 following a settlement that would resolve federal False Claims Act (FCA) and Delaware False Claims and Reporting Act (DFCRA) allegations against Christiana Care Health System (CCHS).
The case, which was initiated by a whistleblower, alleges that CHSS provided free or below-market value support services to non-employee doctors, who then referred patients to CHSS. These referrals in turn led to CHSS billing Medicaid.
State and federal authorities maintain that the providing of these free or below-market value support services induced referrals in violation of Delaware’s Patient Brokering and Anti-Kickback laws. Because the inducements were unlawful, any resulting billing to Medicaid was a false (fraudulent) claim, and thus illegal under the FCA and DFCRA.
“Kickbacks harm us all by inducing improper billing to the State’s Medicaid program,” Attorney General Jennings said. “The Delaware Department of Justice will continue to protect our state’s healthcare programs from fraud.”
The settlement resolves allegations that CHSS submitted, or caused the submission of, false claims to Medicaid by providing support services (including CHSS nurse practitioners, hospitalists, and physician assistants) to non-CHSS physicians at no cost or below fair market value. The alleged false claims occurred between April 1, 2011, and September 30, 2013, with respect to the CHSS neonatology...
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