Halifax Hospital Whistleblower to Receive $20 Million Award in Medicare Fraud Settlement By Tod Aronovitz | 03/13/14 | 0 Comment

The U.S. Department of Justice announced that it reached an $85 million agreement with Halifax Hospital Medical Center and Halifax Staffing Inc., to settle allegations stemming from a whistleblower complaint in 2009 that charged the Daytona Beach-area hospital system with filing false Medicare claims and unlawfully paying doctors.

Elin Baklid-Kunz, a director of physician services who filed the suit under the qui tam provisions of the False Claims Act, will receive $20.8 million of the settlement, according to federal authorities. The Act also permits the government to intervene, as it did in 2011, in some of Baklid-Kunz’s allegations involving Halifax’s violation of the Stark Law. This law prohibits a hospital from billing Medicare for certain services referred by physicians who have a financial relationship with the hospital.

The government alleged that Halifax’s contracts with six medical oncologists broke the law because they paid an incentive bonus that illegally included the value of prescription drugs and tests that the oncologists ordered and Halifax billed to Medicare.  Allegations also claim that Halifax paid three neurosurgeons more than fair market value of their work.

The hospital admits no liability under the terms of the settlement; however, it will also enter into a Corporate Integrity Agreement with the Department of Health and Human Services Office of Inspector General (HHS-OIG).  This agreement requires Halifax to accept considerable internal compliance reforms and to submit its federal health care program claims to independent review for the next five years.

“This settlement illustrates our firm commitment to pursue health care fraud,” the U.S. Attorney for the Middle District of Florida A. Lee Bentley III said.  “Medical service providers should be motivated, first and foremost, by what is best for their patients, not their pocketbooks.  Where necessary, we will continue to investigate and pursue these violations in our district.”

How to Report Miami Medicare Fraud

Healthcare or medical billing employees who have inside knowledge of questionable Medicare billing practices can file a confidential legal claim under the False Claims Act. By acting as a “whistleblower” in what is known as a “qui tam” lawsuit, a private party may collect between 10 to 30 percent of the amount recovered, depending on how the case is prosecuted.

ARONOVITZ LAW: Miami Whistleblower / Qui Tam Law Firm

The Miami Qui Tam law firm of ARONOVITZ LAW routinely works with Miami whistleblowers to document Medicare fraud and other forms of fraud against the government. Contact Miami Whistleblower / Qui Tam lawyer Tod Aronovitz to discuss a case.