hospital

Four Individuals and Three Corporations Convicted for Roles in Wire Fraud Conspiracy at New York Presbyterian Hospital

A Manhattan jury today convicted four individuals and three corporations for their participation in an eight-year conspiracy, involving kickbacks in excess of $2 million, to defraud New York Presbyterian Hospital.



  • OPA Press Releases

hospital

Fourteen Hospitals to Pay U.S. More Than $12 Million to Resolve False Claims Act Allegations Related to Kyphoplasty

Fourteen hospitals located in New York, Mississippi, North Carolina, Washington, Indiana, Missouri and Florida have agreed to pay the United States a total of more than $12 million to settle allegations that the health care facilities submitted false claims to Medicare, the Justice Department announced today.



  • OPA Press Releases

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Assistant Administrator of Houston Hospital Indicted for Alleged Role in $116 Million Medicare Fraud Scheme

An indictment filed in the Southern District of Texas and unsealed today charges Mohammed Khan, 62, of Houston, with one count of conspiracy to commit health care fraud, one count of conspiracy to pay and receive illegal health care kickbacks and five counts of paying or offering to pay health care kickbacks.



  • OPA Press Releases

hospital

Assistant Administrator of Houston Hospital Pleads Guilty to Participating in $116 Million Medicare Fraud Scheme

Mohammad Khan, 62, of Houston, pleaded guilty before U.S. District Judge Sim Lake in the Southern District of Texas to one count of conspiracy to commit health care fraud, one count of conspiracy to defraud the United States and to pay and receive illegal health care kickbacks, and five counts of paying or offering to pay health care kickbacks.



  • OPA Press Releases

hospital

New Jersey Hospital Pays U.s. $8,999,999 to Settle False Claims Act Allegations

AHS Hospital Corp., Atlantic Health System Inc., and Overlook Hospital, located in New Jersey, have agreed to pay the United States $8,999,999 to settle allegations that they violated the False Claims Act, the Justice Department announced today.



  • OPA Press Releases

hospital

Two Individuals Sentenced to Prison for Participating in Kickback Scheme at New York Presbyterian Hospital

Two individuals and three corporations were sentenced in the U.S. District Court in Manhattan by Judge George B. Daniels today to serve time in prison and to pay criminal fines for their participation in an eight-year conspiracy involving kickbacks in excess of $2.3 million to defraud New York Presbyterian Hospital.



  • OPA Press Releases

hospital

Owner of Insulation Service Company Pleads Guilty to Million Dollar Bid-Rigging and Fraud Conspiracies at New York City Hospital

The owner of a former New York City insulation service company pleaded guilty today to a three-count indictment charging him with conspiring to rig bids on contracts for re-insulation services to New York Presbyterian Hospital, conspiring to defraud the Internal Revenue Service and filing a false tax return.



  • OPA Press Releases

hospital

Two Former Hospital Employees Plead Guilty to Participating in Kickback Scheme at New York City Hospital

Two former high-ranking employees of facilities operations at New York Presbyterian Hospital (NYPH) pleaded guilty today to an indictment charging them with conspiring to defraud NYPH.



  • OPA Press Releases

hospital

Hospital Chain HCA Inc. Pays $16.5 Million to Settle False Claims Act Allegations Regarding Chattanooga, Tenn., Hospital

HCA Inc., one of the nation’s largest for-profit hospital chains, has agreed to pay the United States and the state of Tennessee $16.5 million to settle claims that it violated the False Claims Act and the Stark Statute, the Department of Justice announced today.



  • OPA Press Releases

hospital

Two Former Hospital Employees Sentenced to Serve Time in Prison for Participating in Kickback Schemes at New York City Hospital

Two former high-ranking employees of facilities operations at New York Presbyterian Hospital (NYPH) were sentenced in U.S. District Court for the Southern District of New York, in Manhattan, by Judge George B. Daniels today for their participation in two separate conspiracies involving kickbacks.



  • OPA Press Releases

hospital

Missouri Hospital System Agrees to Pay $9.3 Million to Resolve False Claims Act and Stark Law Violations

Freeman Health System, a healthcare provider and hospital system located in Joplin, Mo., has agreed to pay $9,316,139 to resolve allegations that it violated the Stark Law and the False Claims Act by knowingly providing incentive pay to physicians in a manner that violated federal law, the Justice Department announced today.



  • OPA Press Releases

hospital

Group of Owned and Affiliated Florida Hospitals Agree to Pay US $10.1 Million to Resolve False Claims Act Allegations

Morton Plant Mease Health Care Inc. and its affiliated hospitals (Morton Plant) have agreed to pay $10,169,114 to the federal government to resolve allegations that they violated the False Claims Act by submitting false claims for services rendered to Medicare patients, the Justice Department announced today. Morton Plant owns and operates, or is affiliated with, Morton Plant Hospital, St. Joseph’s Hospital, Morton Plant North Bay Hospital, St. Anthony’s Hospital, Mease Countryside Hospital and Mease Dunedin Hospital. These hospitals are part of the BayCare Health System in Florida’s Pinellas, Hillsborough and Pasco counties.



  • OPA Press Releases

hospital

Justice Department Settles Immigration-Based Discrimination Claim Against New York Hospital

The Justice Department announced today that it reached an agreement with Holliswood Hospital, a hospital in Queens, N.Y., resolving claims that the hospital violated the anti-discrimination provision of the Immigration and Nationality Act (INA), when it required newly hired lawful permanent residents to provide more or different documents during the Form I-9 employment eligibility verification process.



  • OPA Press Releases

hospital

Department of Justice Will Not Challenge Proposed New York Hospital Association Gainsharing Program

The Department of Justice announced today that it will not challenge a proposal by the Greater New York Hospital Association (GNYHA) to offer a gainsharing program to member hospitals in New York.



  • OPA Press Releases

hospital

Maryland’s St. Joseph’s Medical Center Agrees to Pay $4.9 Million for Medically Unnecessary Hospital Admissions

St. Joseph’s Medical Center, a hospital located in Towson, Md., has reached a settlement with the United States to pay $4.9 million in connection with its submission of false claims to Medicare, Medicaid and other federal healthcare programs.



  • OPA Press Releases

hospital

Justice Department Settles with Ohio Hospital Over HIV Discrimination

The Justice Department announced today that, as part of its Barrier-Free Health Care Initiative, it has reached a settlement with Glenbeigh Hospital of Rock Creek, Ohio, under the Americans with Disabilities Act.



  • OPA Press Releases

hospital

Montana Hospitals Agree to Pay $3.95 Million to Resolve Alleged False Claims Act and Stark Law Violations

St. Vincent Healthcare, a hospital located in Billings, Mont., and Holy Rosary Healthcare, a hospital located in Miles City, Mont., have agreed to pay $3.95 million plus interest to resolve allegations that they violated the Stark Law and the False Claims Act by improperly providing incentive pay to physicians that made referrals to the hospitals.



  • OPA Press Releases

hospital

Executives from Miami-Area Mental Health Care Hospital Convicted for Participating in $70 Million Medicare Fraud Scheme

A federal jury today convicted four individuals for their participation in a Medicare fraud scheme involving nearly $70 million in fraudulent billings by Hollywood Pavilion (HP), a mental health care hospital.



  • OPA Press Releases

hospital

Fifty-Five Hospitals to Pay U.S. More Than $34 Million to Resolve False Claims Act Allegations Related to Kyphoplasty

Fifty-five hospitals located throughout twenty-one states have agreed to pay the United States a total of more than $34 million to settle allegations that the health care facilities submitted false claims to Medicare for kyphoplasty procedures.



  • OPA Press Releases

hospital

Dubuis Health System and Southern Crescent Hospital for Specialty Care, Inc. to Pay U.S. $8 Million to Resolve False Claims Act Allegations

Dubuis Health System and Southern Crescent Hospital for Specialty Care, Inc. (Southern Crescent) have agreed to pay the United States $8,000,000 to settle allegations that they submitted false claims to Medicare, the Justice Department announced today. Dubuis Health System manages long-term acute care hospitals in multiple states, including Southern Crescent. Southern Crescent is a long-term acute care hospital located in Riverdale, GA and is part of the CHRISTUS Health System.



  • OPA Press Releases

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Shands Healthcare to Pay $26 Million to Resolve Allegations Related to Inpatient Stays at Six Florida Hospitals

Shands Teaching Hospital & Clinics Inc., Shands Jacksonville Medical Center Inc. and Shands Jacksonville Healthcare Inc., which operates a network of health care providers in Florida, will pay the government and the state of Florida a total of $26 million to settle allegations that six of its health care facilities submitted false claims to Medicare, Medicaid and other federal health care programs for inpatient procedures that should have been billed as outpatient services.



  • OPA Press Releases

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Florida Doctors, Hospitals and Clinics to Pay $3.5 Million to Settle Allegations of Improper Medicare, Medicaid and TRICARE Billing

Radiation oncology providers in Pensacola, Fla., will pay $3.5 million to the government and the state of Florida to resolve allegations that they billed Medicare, Medicaid and TRICARE – the health care program for uniformed service members, retirees and their families worldwide – for radiation oncology services that were not eligible for payment.



  • OPA Press Releases

hospital

Patient Broker of South Florida Psychiatric Hospital Sentenced for Role in $67 Million Health Care Fraud Scheme

A patient broker of a South Florida psychiatric hospital was sentenced today to serve 24 months in prison followed by three years of supervised release for her participation in a $67 million Medicare fraud scheme.



  • OPA Press Releases

hospital

Government Intervenes in False Claims Lawsuit Against Ipc the Hospitalist Co. Inc. Alleging Overbilling of Physician Services

The government has intervened in a lawsuit against IPC The Hospitalist Co. Inc., and its subsidiaries (IPC), alleging that IPC submitted false claims to federal health care programs, the Justice Department announced today. IPC, based in North Hollywood, Calif., is one of the largest providers of hospitalist services in the United States, employing physicians and other health care providers who work in more than 1,300 facilities in 28 states. Hospitalists are physicians who work only in hospitals and other long-term care facilities, overseeing and coordinating inpatient care from admission to discharge.



  • OPA Press Releases

hospital

Colorado Health Care Organization and One of Its Montana Hospitals to Pay $3.85 Million for Allegedly Providing Financial Benefits to Referring Physicians and Physician Groups

St. James Healthcare (St. James), a hospital located in Butte, Mont., and its parent company, Sisters of Charity of Leavenworth Health System (Sisters of Charity), a health care organization based in Denver, Colo., have agreed to pay $3.85 million to resolve allegations that they violated the Anti-Kickback Statute, the Stark Law and the False Claims Act by improperly providing financial benefits to physicians and physician groups that made referrals to the hospital.



  • OPA Press Releases

hospital

Government Intervenes in Lawsuits Against Health Management Associates Inc. Hospital Chain Alleging Unnecessary Inpatient Admissions and Payment of Kickbacks

The government has intervened in eight False Claims Act lawsuits against Health Management Associates Inc. (HMA) alleging that HMA billed federal health care programs for medically unnecessary inpatient admissions from the emergency departments at HMA hospitals and paid remuneration to physicians in exchange for patient referrals.



  • OPA Press Releases

hospital

Kentucky Hospital Agrees to Pay Government $16.5 Million to Settle Allegations of Unnecessary Cardiac Procedures

Saint Joseph Health System Inc. has agreed to pay $16.5 million to resolve allegations that Saint Joseph Hospital violated the False Claims Act by submitting false claims to the Medicare and Kentucky Medicaid programs for a variety of medically unnecessary cardiac procedures, the Justice Department announced today.



  • OPA Press Releases

hospital

Government Intervenes in Lawsuit Against Tenet Healthcare Corp. and Georgia Hospital Owned by Health Management Associates Inc. Alleging Payment of Kickbacks

The government has intervened in a False Claims Act lawsuit against Tenet Healthcare Corp. (Tenet) and four of its hospitals in Georgia and South Carolina, as well as a hospital in Monroe, Ga., owned by Health Management Associates Inc. (HMA), alleging that the hospitals paid kickbacks to obstetric clinics serving primarily undocumented Hispanic women in return for referral of those patients for labor and delivery at the hospitals.



  • OPA Press Releases

hospital

Statement on Attorney General Eric Holder’s Discharge from Hospital

Director of Public Affairs Brian Fallon released the following statement this afternoon.



  • OPA Press Releases

hospital

Florida Hospital System Agrees to Pay the Government $85 Million to Settle Allegations of Improper Financial Relationships with Referring Physicians

Halifax Hospital Medical Center and Halifax Staffing Inc. (Halifax), a hospital system based in the Daytona Beach, Fla., area, have agreed to pay $85 million to resolve allegations that they violated the False Claims Act by submitting claims to the Medicare program that violated the Physician Self-Referral Law, commonly known as the Stark Law.



  • OPA Press Releases

hospital

Memorial Hospital in Ohio Pays Government $8.5 Million to Settle False Claims Act Allegations

Memorial Hospital (Memorial), an Ohio nonprofit corporation that operates an acute care hospital in Fremont, Ohio, has agreed to pay $8.5 million to settle claims that it violated the False Claims Act, the Anti-Kickback Statute and the Stark Statute by engaging in improper financial relationships with referring physicians.



  • OPA Press Releases

hospital

Owners of Two Houston-Area Home Health Care Companies, Doctor, and Hospital Employee Sentenced for Their Roles in $3 Million Medicare Fraud Scheme

Owners of two home health agencies, a doctor, and a hospital employee who sold patient information were all sentenced today for their roles in an $3 million Medicare fraud scheme



  • OPA Press Releases

hospital

Alabama Hospital Employee Pleads Guilty to Identity Theft

Kamarian D. Millender, of Dothan, Alabama, pleaded guilty today to one count of aggravated identity theft , Deputy Assistant Attorney General Ronald A. Cimino of the Justice Department's Tax Division and U.S. Attorney George L. Beck Jr. for the Middle District of Alabama announced



  • OPA Press Releases

hospital

Alabama Hospital System and Physician Group Agree to Pay $24.5 Million to Settle Lawsuit Alleging False Claims for Illegal Medicare Referrals

Mobile, Alabama-based Infirmary Health System Inc. (IHS), two IHS-affiliated clinics and Diagnostic Physicians Group P.C. (DPG) have agreed to pay the United States $24.5 million to resolve a lawsuit alleging that they violated the False Claims Act by paying or receiving financial inducements in connection with claims to the Medicare program, the Justice Department announced today



  • OPA Press Releases

hospital

Co-Owner of Atlanta-Based Medical Clinic Chain and Hospital CEO Pleaded Guilty to Illegal Pay-for-Patient Conspiracy

A CEO of an Atlanta-area hospital and the co-owner and chief operating officer of an Atlanta-based medical clinic chain pleaded guilty in connection with the payment of illegal kickbacks to clinics in exchange for Medicaid patient referrals to hospitals in the Atlanta area and on Hilton Head Island, South Carolina



  • OPA Press Releases

hospital

Justice Department Asks Court to Dismiss Saint Elizabeths Hospital Case After Conditions Improved Under Consent Decree

Today, the Justice Department asked a federal court to dismiss the injunction to address civil rights violations at Saint Elizabeths Hospital in Washington, D.C., because the District of Columbia and the Department of Behavioral Health have significantly improved the care and treatment of persons confined to Saint Elizabeths Hospital. Saint Elizabeths is the district’s facility for treating individuals with mental health conditions. The reforms, which were implemented following requirements under a court order, have ensured that persons at Saint Elizabeths Hospital are discharged to the community with adequate supports to live in integrated settings. Further, the reforms resulted in important improvements in integrated treatment planning, psychological and psychiatric services, nursing care and protection from assault.



  • OPA Press Releases

hospital

Sanofi and Regeneron provide update on U.S. Phase 2/3 adaptive-designed trial in hospitalized COVID-19 patients

• Independent Data Monitoring Committee recommended continuing ongoing Phase 3 trial only in the more advanced “critical” group with Kevzara higher-dose versus placebo and discontinuing less advanced “severe” group




hospital

COMIC: Hospitals Turn To Alicia Keys, U2 And The Beatles To Sing Patients Home

Call them victory anthems. Every time a patient with COVID-19 is well enough to be discharged, hospitals in New York and elsewhere play songs of celebration over the intercom. A doctor explains.




hospital

Mystery syndrome similar to Kawasaki disease linked to coronavirus at Children's Hospital Los Angeles

Doctors have recently identified a condition called pediatric inflammatory multi-system syndrome among children who have tested positive for antibodies against COVID-19.




hospital

Pharmacy Compounders Practicing Pursuant to Section 503A Can Get in the Mix: Compounding Shortage Drugs for Hospital Patients, with Some Limitations

By Karla L. Palmer



  • COVID19
  • Prescription Drugs and Biologics

hospital

Birx to help lead remdesivir distribution effort as hospitals struggle to access drug

Since the drug was granted emergency use authorization, doctors have been left with no clear path to get it.





hospital

Hospitalization for infection on the rise in gout




hospital

Recruitment for director and research principal investigators of Shanghai Key Laboratory of Tissue Engineering Research, at Shanghai Ninth People's Hospital, Shanghai Jiao Tong University

Position
Laboratory director and independent principal investigators

Employer
Shanghai Ninth People’s Hospital affiliated to Shanghai Jiao Tong University School of Medicine

Location
639 Zhi Zao Ju Rd, Huang Pu District, 200011, Shanghai, China

Discipline
Tissue engineering and regenerative medicine related disciplines including: Stem Cell, Developmental Biology, Biomaterials, Biomedical Engineering

Aim:
Shanghai Tissue Engineering Key Laboratory is among the l…




hospital

Bottas remains a doubt after night in hospital

Valtteri Bottas remains a doubt for Sunday's Australian Grand Prix after spending the night in hospital with soft tissue damage to his back




hospital

Schumacher turns 45 in hospital as Ferrari sends wishes

Michael Schumacher is spending his 45th birthday in hospital as doctors continue to monitor his condition following his skiing accident




hospital

Schumacher out of coma and leaves Grenoble hospital

Michael Schumacher's management has confirmed he has left hospital and is no longer in coma




hospital

Hospitals as community hubs: Integrating community benefit spending, community health needs assessment, and community health improvement


Much public focus is being given to a broader role for hospitals in improving the health of their communities. This focus parallels a growing interest in addressing the social determinants of health as well as health care policy reforms designed to increase the efficiency and quality of care while improving health outcomes.

This interest in the community role of hospitals has drawn attention to the federal legal standards and requirements for nonprofit hospitals seeking federal tax exemption. Tax-exempt hospitals are required to provide community benefits. And while financial assistance to patients unable to pay for care is a basic requirement of tax-exemption, IRS guidelines define the concept of community benefit to include a range of community health improvement efforts.

At the same time, the IRS draws a distinction between community health improvement spending–which it automatically considers a community benefit–and certain “community-building” activities where additional information is required in order to be compliant with IRS rules. In addition, community benefit obligations are included in the Affordable Care Act (ACA).

Specifically, the ACA requires nonprofit hospitals periodically to complete a community health needs assessment (CHNA), which means the hospital must conduct a review of health conditions in its community and develop a plan to address concerns. While these requirements are causing hospitals to look more closely at their role in the community, challenges remain. For instance, complex language in the rules can mean hospitals are unclear what activities and expenditures count as a “community benefit.” Hospitals must take additional steps in order to report community building as community health improvement.

These policies can discourage creative approaches. Moreover, transparency rules and competing hospital priorities can also weaken hospital-community partnerships. To encourage more effective partnerships in community investments by nonprofit hospitals:

  • The IRS needs to clarify the relationship between community spending and the requirements of the CHNA. 
  • There needs to be greater transparency in the implementation strategy phase of the CHNA. 
  • The IRS needs to broaden the definition of community health improvement to encourage innovation and upstream investment by hospitals.

Download "Hospitals as Community Hubs: Integrating Community Benefit Spending, Community Health Needs Assessment, and Community Health Improvement" »

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Authors

  • Sara Rosenbaum
      




hospital

Responding to COVID-19: Using the CARES Act’s hospital fund to help the uninsured, achieve other goals

       




hospital

Responding to COVID-19: Using the CARES Act’s hospital fund to help the uninsured, achieve other goals