A California hospital has agreed to pay a $51,000 fine to settle charges that it paid an unnamed third party for Medicare patient referrals in violation of the federal anti-kickback statutes.
Although the settlement amount was nominal, 100-bed VillaView Community Hospital in San Diego is only one of a handful of hospitals nationwide to settle such charges.
The statutes bar any form of remuneration to induce the referral of Medicare or Medicaid patients.
The not-for-profit hospital, which admitted no wrongdoing, signed the settlement in March. MODERN HEALTHCARE obtained a copy of the settlement last week under the federal Freedom of Information Act.
VillaView; Stuart Jed, president of Delta Partners, the management group that operates the hospital; and hospital Administrator Reggie Panis had not returned repeated phone calls for comment.
According to the 14-page settlement, the allegations stem from a June 1996 civil whistleblower fraud lawsuit against VillaView.
The settlement identified the whistleblower as James Moore, but did not reveal his relationship to the hospital or connection to the allegations.
In his lawsuit, filed in U.S. District Court in San Diego, Moore charged that some claims submitted by the hospital to Medicare from 1994 to 1997 were false because they were for patients who were admitted from an illegal kickback scam.
The government has joined the case as a plaintiff, but the case has yet to be unsealed because of an ongoing civil investigation linked to the lawsuit. That investigation may be targeting the unnamed third-party in the alleged cash-for-patients scheme.
The U.S. attorney's office in San Diego, HHS' inspector general's office and the U.S. Justice Department declined to identify the third party, the dollar amount of the alleged fraudulent bills involved, or the amount and nature of the alleged kickbacks.
Assistant U.S. Attorney Stephen Segreto in San Diego said he could not comment on the settlement agreement, other than to say his office is continuing an ongoing civil investigation into the matter.