Issue link: https://beckershealthcare.uberflip.com/i/948573
26 PRACTICE MANAGEMENT Physician-Owned Hospital in Dallas Pays $7.5M to Settle Kickback Allegations: 5 Things to Know By Laura Dyrda P ine Creek Medical Center, a Dal- las-based physician-owned hospital, paid $7.5 million to settle allegations the hospital violated the False Claims Act, according to the Department of Justice. Here are five things to know: 1. e U.S. government alleged Pine Creek illegally paid kickbacks for marketing and/or advertising services on behalf of physicians who referred patients to the hospital, includ- ing Medicare and Tricare beneficiaries. "Healthcare providers that attempt to profit from illegal kickbacks will be held account- able," said Principal Deputy Assistant Attor- ney General Chad Readler, who heads up the Justice Department's Civil Division. "Im- proper financial incentives can distort medi- cal decision making and drive up healthcare costs for federal healthcare programs and their beneficiaries." 2. e hospital allegedly paid for radio and television advertising, pay-per-click cam- paigns, billboards, website upgrades, bro- chures and business cards, as well as other marketing forms, in exchange for patient re- ferrals, according to the DOJ. 3. Pine Creek has agreed to pay $7.5 million to resolve the kickback claims as well as enter into a corporate integrity agreement with the Office of Inspector General. Under the integ- rity agreement, the hospital must undertake substantial internal compliance reforms for the next five years. 4. e allegations were originally brought in a whistleblower lawsuit under the qui tam pro- vision of the False Claims Act, allowing private parties to bring suits on behalf of the govern- ment. e whistleblower is able to share in the recovery, and in this case the former Pine Creek marketing department employee who filed the suit will receive $1.125 million. 5. e U.S. government will continue to pur- sue kickback cases aggressively, according to the DOJ's release. "Hospitals that try to boost their profits by paying kickbacks to physicians will instead pay for their improper conduct," said Special Agent in Charge of the OIG's Dallas Region C.J. Porter. "We will con- tinue to investigate such illegal business ar- rangements that undermine impartial medi- cal judgment." n Cookeville Center for Pain Management Owner to Pay $1.45M for Prescribing 'Useless' Painkillers By Eric Oliver M atthew Anderson and his management company, PMC, will pay $1.45 million to settle claims Cookeville (Tenn.) Center for Pain Management and its employees improperly billed Medicare and TennCare for painkillers, the Herald Citizen reports. Here's what you should know: 1. Federal authorities allege between 2011 and 2014, employees of the pain center wrote prescriptions for painkillers that served "no le- gitimate medical purpose." Authorities also said Mr. Anderson made the Cookeville clinic as well as three other clinics overbill Medicare for performed services, and he allowed two nurse practitioners to practice medicine while not under a physician's supervision. 2. Mr. Anderson agreed to settle those claims for $1.45 million. Ad- ditionally, Cindy Scott, a nurse practitioner, will pay $32,000 and surrender her DEA registration until October 2021. She will not be allowed to prescribe medicine until she renews her registration. 3. A former office manager with the clinic filed a whistleblower law- suit against Mr. Anderson, Ms. Scott and the pain clinics. As a result of her actions, she'll be compensated. 4. U.S. Attorney Don Cochran said, "As evidenced here, we will use all available resources, including civil remedies, to pursue those whose actions continue to fuel the opioid epidemic plaguing our nation." n Penn Orthopaedics, Princeton Orthopedic Associates Create Cross-State Partnership — 4 Insights By Megan Wood P hiladelphia-based Penn Orthopaedics and Princeton (N.J.) Orthopedic Associates are teaming up to provide cross-state care, ac- cording to Philadelphia Business Journal. Here are four insights: 1. The collaboration came out of Princeton Healthcare System joining the Penn Medicine umbrella. 2. The two groups plan to leverage their alliance to boost patient access to high-quality orthope- dic care as well as collect data to push research. 3. Princeton Orthopedic Associates encompass- es 25 physicians and five locations in Central Jer- sey, led by President Stuart Levin, MD. 4. Penn Orthopaedics includes 48 physicians at 14 locations in Pennsylvania and South Jersey. n