Home Health & Hospice Week

Pennsylvania provider pays high 6 figures to settle Stark Law charges.

A recent False Claims Act settlement revolving around noncompliant medical director payments may prove a good warning for home health agencies.

Nonprofit Pennsylvania health system Penn Highlands Healthcare and several of its hospitals have agreed to pay $735,000 to settle charges that it violated the Stark self-referral law by “paying improper compensation to referring physician Gary Ott, M.D., and to a physician employed by … Dr. Ott’s practice, in the amount of $420,000,” the Department of Justice says. The system made the payments from 2009 to 2012 “under a Consulting, Medical Director and Related Services Agreement for ‘employment services’ allegedly performed before the agreement went into effect,” the DOJ notes.

Qui tam bounty: Three medical providers formerly employed by Penn Highlands, Tuesdae Stainbrook, Mary Simpson, and Jonathan Pope, filed a whistleblower suit in 2016 initiating the case, and will receive more than $150,000 of the settlement, the DOJ highlights.

“The United States’ intervention and settlement in this matter illustrates the government’s emphasis on combating healthcare fraud,” the DOJ stresses. “One of the most powerful tools in this effort is the False Claims Act,” Justice says, highlighting the HHS Office of Inspector General’s reporting channels at 1-800-HHS-TIPS (1-800-447-8477) or https://oig.hhs.gov/fraud/report-fraud.