Halifax Hospital Medical Center and Halifax Staffing Inc. of Florida agreed to pay $85 million to settle a part of a whistleblower fraud case just before trial was scheduled to begin on March 3, thereby resolving allegations of violations of the False Claims Act by submitting claims to the Medicare program resulting from an allegedly illegal physician self-referral arrangement. According to the Department of Justice (DOJ), Halifax agreed to a five-year corporate integrity agreement (CIA) with the Health and Human Services Office of Inspector General (OIG) that includes substantial internal compliance reforms including submitting its federal health care claims to an independent review for the period of the CIA. The IG, Daniel R. Levinson, says Halifax is also required to hire a legal reviewer to monitor its contracts and agreements with other providers and a compliance expert to assist the board in fulfilling its oversight obligations. “Both of these independent reviewers will submit regular reports to my agency,” Levinson said. The whistleblower in this case, Elin Baklid-Kunz, will receive $20.8 million of the settlement. The DOJ announcement says that the claims settled under this agreement are allegations only and there has been no determination of liability except as determined by […]
Halifax Hospital Medical Center and Halifax Staffing Inc. of Florida agreed to pay $85 million to settle a part of a whistleblower fraud case just before trial was scheduled to begin on March 3, thereby resolving allegations of violations of the False Claims Act by submitting claims to the Medicare program resulting from an allegedly illegal physician self-referral arrangement.
According to the Department of Justice (DOJ), Halifax agreed to a five-year corporate integrity agreement (CIA) with the Health and Human Services Office of Inspector General (OIG) that includes substantial internal compliance reforms including submitting its federal health care claims to an independent review for the period of the CIA. The IG, Daniel R. Levinson, says Halifax is also required to hire a legal reviewer to monitor its contracts and agreements with other providers and a compliance expert to assist the board in fulfilling its oversight obligations. “Both of these independent reviewers will submit regular reports to my agency,” Levinson said.
The whistleblower in this case, Elin Baklid-Kunz, will receive $20.8 million of the settlement. The DOJ announcement says that the claims settled under this agreement are allegations only and there has been no determination of liability except as determined by the court in a Nov. 13, 2013, decision.
Halifax Still Not Out of the Woods
A report in the March 10 Daytona Beach News Journal says that the government settlement does not include another part of the suit involving allegations of unnecessary hospital admissions which is set for trial in July. That part of the case involves potential damages and penalties in excess of $240 million according to Marlan Wilbanks, an attorney for Baklid-Kunz. The government declined to intervene on those claims. The attorneys are also entitled to ask for fees and costs related to the case. Halifax has consistently denied the allegations brought by the whistleblower.
Takeaway: There are many reasons government prosecutors choose to intervene or not in a whistleblower case, but their absence does not lessen the validity of the case nor determine if it will proceed or not.
