Columbia/HCA Healthcare Corp. has settled a second whistleblower fraud lawsuit for the nominal amount of $81,000, MODERN HEALTHCARE has learned.
Neither Columbia, the nation's largest hospital chain, nor the plaintiff, a former quality assurance employee at one of the company's Chicago-area hospitals, has announced the settlement.
U.S. District Court Judge Elaine Bucklo in Chicago, where the suit was filed, dismissed the case Aug. 11 after the U.S. Justice Department approved the settlement, according to a lawyer close to the case.
The lawsuit was one of three civil whistleblower fraud cases pending against Nashville-based Columbia that have been unsealed and that the government has declined to join as a co-plaintiff. The government has joined five other lawsuits that have been unsealed.
Columbia and the Justice Department recently filed a motion with a special judicial panel to consolidate those five cases and 18 others that are still sealed. That would facilitate a one-time global settlement that could approach $1 billion (See story, p. 32).
The relatively small settlement in the latest case points to a plaintiff's disadvantage when the government is not in his or her corner.
Under the deal, Columbia paid $56,000 to the whistleblower, Mary Ann Wisz, who worked in the quality assurance department at Olympia Fields (Ill.) Regional Osteopathic Medical Center from August 1995 through December 1996. The $25,000 balance went to Wisz's lawyer.
Wisz sued Columbia in April 1997. She alleged that Columbia executives at Olympia Fields, which Columbia still owns, and at Chicago Osteopathic Hospital, which Columbia closed in 1997, ordered surgical nurses to upcode outpatient surgeries as inpatient procedures and to upcode minor surgeries as major ones. Both alleged schemes were designed to increase payments from Medicaid.
Wisz alleged that the fraud occurred from 1993 to 1997 but never specified the amount of money the scheme allegedly yielded the two hospitals.
The government said in January that it would not join the lawsuit as a plaintiff. In keeping with government policy, it did not give a reason. Columbia settled without admitting wrongdoing in the matter.
Columbia spokesman Jeffrey Prescott said some of the whistleblower suits allege broad, systemwide fraud, while others, such as Wisz's, focus on allegations peculiar to a single hospital or local healthcare system.
The Wisz settlement "is good for those of us bringing systemwide cases," said San Francisco lawyer Stephen Meagher, who represents plaintiffs in two whistleblower lawsuits that the feds have joined. "Our worst nightmare is that the settlement gets held up by someone with a small, localized claim."
Columbia settled its first whistleblower suit in July, when it agreed to pay $1.3 million to settle charges that one of its psychiatric hospitals, 56-bed Columbia Brunswick Hospital in Supply, N.C., filed false claims with the North Carolina Medicaid program (Aug. 2, p. 4).