DOJ Announces $3.2 Million Settlement with California Hospital Over Alleged Stark Law Violations

The Department of Justice recently announced a $3.2 Million settlement with Tri-City Medical Center related to allegations it violated the Stark Law and False Claims Act.  Tri-City Medical Center, a hospital in Oceanside, California, allegedly maintained financial arrangements with community-based physicians and physician groups that failed to comply with the Stark Law.   Stark, the physician self-referral law, forbids a hospital from billing Medicare for certain services referred by physicians who have a financial relationship with the hospital unless that… Read More >

Improper Management Agreements Serve as Basis for $10 Million Dollar Settlement

The Department of Justice (DOJ) released a statement on March 31, 2015 discussing a recent settlement agreement with Robinson Health System, Inc., based in Ohio. The settlement arose from allegations that the health system had violated both the Anti-Kickback Statute and the Stark self-referral prohibition by entering into management agreements with physician groups who allegedly did not provide sufficient bona fide management services to justify the amount of the payments. This settlement is a good reminder to physician groups and… Read More >

Anti-Kickback and Stark Law Whistleblower Suit Results in $24.5 Million Settlement

The Department of Justice released a statement on Monday July 21, 2014 discussing a recent $24.5 million settlement with Alabama-based Infirmary Health System Inc. (IHS), two IHS-affiliated clinics and Diagnostic Physicians Group, P.C. (DPG).  The settlement resolved a lawsuit alleging violations of the False Claims Act as a result of claims submitted in violation of the Anti-Kickback Statute and the Stark Law. The government’s lawsuit, which was initiated by a whistleblower, alleged that the hospital affiliated clinics entered into an… Read More >

Stark Law Recognizes Same Sex Marriages for Purposes of Immediate Family Member Definition

CMS recently updated its Frequently Asked Questions related to the prohibition on physician self-referral to be consistent with Department policy to treat same-sex marriages “on the same terms as opposite sex marriages to the greatest extent reasonably possible.” In reaction to the Supreme Court’s decision in United States v Windsor, where the Court found part of the Defense of Marriage Act unconstitutional, CMS clarified that the definition of an “immediate family member” of a physician does include the lawfully married same-sex… Read More >