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Fraud-Based Whistleblower Suit Yields Adverse Result For Hospital

When we note on our health law representation website at the well-established New York law firm of Daniels, Porco & Lusardi, LLP, that our deep legal team is “prepared to resolve any type of health care dispute that may arise for a care-delivery professional or business,” that is actually saying a lot.

And here’s why: Unquestionably, the legal challenges that confront medical entities both potentially and in imminently real ways span a wide — even seemingly unlimited — universe of possibilities.

Truly, any list of possible risk-and-liability enhancers facing actors in the medical realm can seem almost endless. Challenges range broadly from allegations of medical incompetence and regulatory failure-to-comply issues to claimed licensing irregularities, medical device glitches and myriad other matters.

Like health-care fraud, for instance, which comprises a top-tier and especially writ-large focus these days of state and federal regulators overseeing the medical industry.

Stories in New York and across the country routinely emerge to spotlight alleged health care fraud being perpetrated by a hospital or other industry actor.

The repercussions for a targeted facility can be flatly dire, even draconian, as was recently underscored in the wake of a settlement between one medical center and government officials.

In that matter, a defendant hospital in a federal whistleblower lawsuit alleging Medicare fraud agreed to pay $42 million to federal and state regulators, respectively, following claims that its principals engaged in a sustained and unlawful relationship with select doctors.

Authorities specifically contended that the hospital illegally offered those physicians kickbacks for referring patients. Such a relationship violates both federal and state laws. The settlement additionally addressed false billings to the government Medicare program.

A government official says that the litigation result serves as an admonitory warning to care providers that “seek to boost profits by entering into improper financial arrangements with referring physicians.”

Notwithstanding its agreement to pay, the hospital did not admit to any wrongdoing.


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