The government began investigating the health systems, collectively referred to as Methodist, after the former president of Methodist University Hospital, Jeffrey H. Liebman, filed a lawsuit under the whistleblower provisions of the False Claims Act in May 2017.
The alleged fraudulent behavior started when Methodist purchased all of the outpatient locations in West’s oncology practice in Memphis, Tennessee. Methodist had not had its own comprehensive cancer treatment center at the time.
The transaction aimed to allow West patients to receive outpatient and inpatient services at Methodist locations by West physicians. Meanwhile, West would provide management services to Methodist’s adult oncology service line.
The entities described the deal as a partnership that would achieve a cancer center without walls, but they never created a formal partnership as it would have violated regulatory requirements.
Methodist received increased Medicare reimbursement for cancer care as a part of the deal, the complaint stated. Methodist billed Medicare for the facility and professional components of the outpatient treatment, chemotherapy, and other drugs. This allowed Methodist to receive cost discounts through the 340B Discount Drug program, resulting in $50 million in profits in one year.
DOJ alleged that Methodist violated the False Claims Act, which states that it is illegal for companies to knowingly submit fraudulent Medicare or Medicaid claims.
Methodist also...
A front-page article with the byline of veteran New York Times opinion writer Nicholas Kristof is the latest poisonous example of what I call the NGO “halo effect.” Headlined “The Silence That Mee...