Cleveland Clinic agreed to pay $ 21.25 million to settle a lawsuit alleging that his Akron General Health System improperly paid groups of doctors for patient referrals and filed false claims with Medicare, according to the Justice Department.
Akron General’s former Director of Internal Audit, Beverly Brouse, acted as complainant, denouncing the health care system under the False Claims Act in 2015 in the U.S. District Court for the Northern District of Ohio. DOJ and Cleveland Clinic arrived at the facility in May.
Brouse said she was fired in December 2015 after the Cleveland Clinic acquired Akron General and said that “for at least the last 5 years, [Akron General] engaged in a scheme to pay improper compensation to physicians for illegally inducing them to refer patients, including Medicare, Medicare Advantage and Medicaid patients, to [Akron General] for in-house services and accessories. ”
This compensation was said to include “strong annual wages well above the fair market value of the services rendered,” according to the complaint.
DOJ said the Cleveland Clinic, which acquired Akron General in late 2015, voluntarily disclosed to the government the compensation agreements, which were allegedly created by Akron General’s management. The clinic said it discovered compliance problems with some independent physician group contracts in early 2016.
“We are committed to complying with health laws and regulations throughout our organization, and every employee is responsible for following the rules of our code of conduct,” Cleveland Clinic said in a statement.
Blouse’s lawyer Warner Mendenhall of the Mendenhall Legal Group called the establishment “a positive outcome” for both Brouse and taxpayers.
“We especially appreciate our client for her courage and work with investigators to recover federal funds. Beyond the big result, this type of work brings responsibility to the health care system and protects patients from fraudulent practices by patients. their medical decisions should be about the patient and not financial arrangements, ”Mendenhall said in a statement.