US Files Suit Against WV Hospital, Its Management Company, and Its CEO Based on Kickbacks to Doctors

[TexasTowelie]

WASHINGTON – The United States has filed a complaint under the False Claims Act against Wheeling Hospital, Inc., R & V Associates, Ltd. (R & V), and Ronald Violi in the U.S. District Court for the Western District of Pennsylvania, the Department of Justice announced today. The government has alleged that Wheeling Hospital, which is located in Wheeling, WV, violated the Stark Law and Anti-Kickback Statute, and that those violations were caused by R & V, Wheeling’s contracted management consultant, and Violi, Wheeling’s CEO.

The Stark Law prohibits a hospital from billing Medicare for services referred by physicians who have improper financial relationships with the hospital. The Anti-Kickback Statute prohibits offering or paying anything of value to induce the referral of items or services covered by Medicare, Medicaid, and other federal healthcare programs. The United States alleges that Wheeling’s compensation to a number of employed and contracted physicians violated these statutory prohibitions because that compensation was based on the volume or value of the physicians’ referrals or exceeded the fair market value of the physicians’ services.

"Improper financial arrangements between hospitals and physicians can influence the type and amount of health care that is provided," said Assistant Attorney General Jody Hunt of the Department of Justice’s Civil Division. "The Department is committed to taking action to eliminate improper inducements that can corrupt the integrity of physician decision-making and drive up healthcare costs for all of us."

"Medicare and Medicaid beneficiaries trust that their healthcare providers will make decisions based on sound medical judgment," said U.S. Attorney Scott W. Brady. "Our office will take decisive action against any medical providers who betray that trust and make medical decisions based on their own financial interests."

Read more: https://www.justice.gov/usao-wdpa/pr/united-states-files-suit-against-west-virigina-hospital-its-management-company-and-its

[nitpicker]

1. Background- from the whistleblower's lawyers

https://www.phillipsandcohen.com/government-joins-whistleblower-lawsuit-against-west-virginia-hospital-its-ceo-and-pittsburgh-company/

PITTSBURGH, PA, Dec. 21, 2018 – The US Department of Justice has joined a whistleblower lawsuit filed by Phillips & Cohen LLP that alleges a West Virginia hospital – under the direction of its chief executive officer and management firm – improperly paid millions in excessive compensation to doctors based on the volume or value of patient referrals to the hospital and the money generated for the hospital by the patients’ treatment.

The qui tam lawsuit against Wheeling Hospital, CEO Ronald Violi and his management firm, R&V Associates of Pittsburgh, was unsealed and made public today after the government filed notice with the federal district court in Pittsburgh that it would intervene in the case.

Wheeling Hospital engaged in the scheme, the “qui tam” (whistleblower) lawsuit says, as part of a plan to gain “monopolistic power and dominating market share” in the Ohio Valley region. For some physicians, compensation totaled over $1 million a year.
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