Consumer Fraud

Whistleblower accuses largest U.S. hospital operator of fraud

whistleblower 5 370x210 Whistleblower accuses largest U.S. hospital operator of fraudA former employee of Hospital Corporation of America (HCA), the largest publicly traded hospital system in the nation, filed a whistleblower lawsuit against the company, alleging it subjected patients to medically unnecessary heart surgeries and submitted false claims to the federal government for reimbursement.

Christopher Gentile, who served as the professional liability claims director for an HCA subsidiary in Tennessee, filed the whistleblower lawsuit in February 2012 in a Miami, Fla., federal court. The lawsuit was unsealed on Monday.

Mr. Gentile accuses two HCA hospitals in Florida of performing high-risk, invasive and medically unneeded cardiology procedures on patients so it could bill Medicare for the reimbursement and boost profits. The hospitals named in the lawsuit are Lawnwood Regional Medical Center & Heart Institute in Fort Pierce, Fla., and Regional Medical Center Bayonet Point in Hudson, Fla.

Mr. Gentile filed the lawsuit under the whistleblower provisions of the False Claims Act, which authorizes private citizens to sue on behalf of the U.S. government. Whistleblowers whose False Claims lawsuits lead to a judgment or settlement are awarded up to 30 percent of the total amount recovered.

The whistleblower lawsuit is not the first time that HCA hospitals have been targeted for alleged misconduct. In July 2012, federal prosecutors in Miami notified HCA that they were investigating eight Florida hospitals to find whether some of the cardiology procedures they were performing were medically necessary. That investigation is still active.

Then, in 2002 and 2003, HCA “settled criminal and civil fraud charges for a combined $1.7 billion in 2000 and 2003—at the time the largest settlement from a federal health care probe,” the Wall Street Journal reported. “The charges included improperly billing Medicare and other federal health programs and paying kickbacks to doctors.”

Source:

Wall Street Journal