Intermountain Health Care Settles False Claims Act Allegations for $25.5 Million

May 2, 2013 — When health care providers are engaged in Medicare fraud or other misconduct that violates the False Claims Act, the Act authorizes insider employees and other tipsters to file suit on behalf of the government and retain a portion of anything collected through the legal action. Informants generally receive anywhere from 15 to 25 percent of the recovery.

Utah Health Care Giant Settles Allegations of Stark Statute Violations

Intermountain Health Care Inc. of Utah has settled a False Claims Act case with the United States for $25.5 million. The Justice Department alleged that Intermountain — a health care network with 22 hospitals, 185 physician clinics and 33,000 employees — improperly engaged in prohibited financial relationships with referring physicians, in violation of both the False Claims Act and the Stark Statute.

The Stark Statute disallows certain financial entanglements between a hospital and a doctor that refers patients to the hospital. In the case of Intermountain, the issue concerned employment contracts providing that doctors would receive bonuses tied to the value to the hospital of referral patients. In addition, other compensation schedules and office leases for referring doctors also violated the Stark Statute.

Government Notified of False Claims Act Violations by Insider Employees

In this case, Intermountain self-disclosed its violations to the government, but this is not always the case with other companies that submit false claims to the government or violate the Stark Statute. Frequently, the government is notified about False Claims Act violations from insider informants who work for the health care providers involved in the wrongdoing. Before filing suit, whistleblowers should take the time to learn about their own rights under the qui tam portion of the False Claims Act. The health care fraud attorneys with Waters & Kraus provide tipsters with the aggressive legal representation they need. Send us and email or call our whistleblower lawyers at 855.784.0268 to discuss how we can advance your interests.

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