Although On March 31, 2015, the Department of Justice announced that Robinson Health System, Inc. (“Robinson”), an Ohio-based non-profit corporation, agreed to pay $10 million to resolve allegations that it engaged in improper financial relationships with referring physicians. Robinson operates facilities in Portage County, Ohio, including Robinson Memorial Hospital.
The government alleges that Robinson violated the Anti-Kickback Statute and the Stark Statute because of its financial relationships with a number of referring physicians. The physicians at issue allegedly failed to provide sufficient management services to have justified payments that they received from Robinson pursuant to management agreements that Robinson entered into with two physician groups.
As noted by Steven M. Dettelbach, the U.S. Attorney for the Northern District of Ohio, “[r]eferrals should be made to the best qualified physicians, and must be based on what’s best for the patient. Improper financial relationships between hospitals and referring doctors can lead to clouded judgments, which is why the Department of Justice will continue to police such matters vigorously.”
The investigation of Robinson was handled by the Department of Justice’s Civil Division, in conjunction with the U.S. Attorney’s Office for the Northern District of Ohio. The settlement is part of the government’s Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was initially started in 2009.
Since 2009, the Department of Justice has recovered a total of more than $23.8 billion through False Claims Act cases, with more than $15.2 billion of that amount recovered in cases involving fraud against health care programs. According to Benjamin C. Mizer, the Acting Attorney General for the Justice Department’s Civil Division, “[t]he Department of Justice has longstanding concerns about improper financial relationships between health care providers and their referral sources, because such relationships can alter a physician’s judgment about the patient’s true health care needs and drive up health care costs for everybody. In addition to yielding a recovery for taxpayers, this settlement should deter similar conduct in the future and help to make health care more affordable.”