GREENVILLE, S.C. — A Greenville health care system will pay the federal government $36.5 million to resolve allegations that it violated the False Claims Act, the Federal Stark Law, and the Federal Anti-Kickback Statue.
St. Francis Physician Services, Inc., St. Francis Hospital, and Bon Secours St. Francis Health System, Inc., (collectively, “St. Francis”), owner and operator of the St. Francis healthcare system, a Section 501(c)(3) charitable organization in Greenville allegedly made payments to orthopedic surgeons that were tied to the volume or value of referrals. The settlement resolves allegations that St. Francis caused the submission of false claims to Medicare and TRICARE as a result of an unlawful payment structure between St. Francis and Piedmont Orthopedic Association (POA). Specifically, it is alleged that St. Francis’s bonus payments to POA physicians violated both the Stark Law and the AKS.
The Stark Law, or the Physician Self-Referral Law, prohibits physicians from referring patients to receive "designated health services" payable by Medicare or Medicaid from entities with which the physician or an immediate family member has a financial relationship.
The lawsuit was brought against St. Francis by a realtor under the whistleblower provision of the False Claims Act where a private party can file an action on behalf of the United States and receive a portion of any recovery. The unnamed realtor will receive approximately $10.2 million of the settlement amount, as part of this resolution.
“Medical providers should base health care decisions on what is best for the patient, and not on financial incentives and related schemes,” said U.S. Attorney Adair F. Boroughs for the District of South Carolina. “We are grateful the relator brought these allegations forward. Relators are critical to identifying fraud and protecting the integrity of our Medicare system.”
