Adventist Health System, a Florida-based healthcare company, has agreed to pay a $118.7M settlement to the federal government and four involved states over a whistleblower suit alleging an intricate system of kickbacks to doctors for referring patients. Adventist was allegedly offering doctors bonuses, inflated salaries and permission to overbill in exchange for patient referrals.
Plaintiffs’ lawyers announced Monday that Florida-based Adventist Health System pays $118.7M whistleblower settlement in a suit alleging the healthcare system paid doctors kickbacks for patient referrals. The suit was filed by three of Adventist’s former employees at the Park Ridge Health hospital in Hendersonville, North Carolina in 2012. The settlement agreement also covers claims from a separate 2013 suit regarding similar allegations.
The four affected states (North Carolina, Tennessee, Texas and Florida), as well as the federal government, stepped into the fray after the suit was filed. According to Benjamin Mizer, the head of the DOJ’s Civil Division, “Unlawful financial arrangements between heath care providers and their referral sources raise concerns about physician independence and objectivity. Patients are entitled to be sure that the care they receive is based on their actual medical needs rather than the financial interests of their physician.”
Peter Chatfield, one of the plaintiffs’ lawyers, explained that $115M of the settlement goes to the U.S. government. On top of the kickback claims, Adventist allegedly overbilled government healthcare programs. Florida takes $3.4M with the remaining amount divided between the other three states.
The three plaintiff whistleblowers may get 15% – 25% of the settlement, but the final amount has yet to be determined.
The kickbacks came as bonuses, inflated salaries and permission to overbill if the involved doctors referred patients to Adventist facilities.