The United States has settled a lawsuit with Health Management Associates and the former HMA-owned Clearview Regional Medical Center in Georgia for $595,155, according to the Department of Justice.
As part of the whistleblower provision of the False Claims Act, former CFO Ralph D. Williams will receive $119,031 from the U.S.’s portion of the settlement, according to the June 4 release.
From April to October 2009, Williams was CFO of the former Walton Regional Medical Center, now called Clearview Regional Medical Center and owned by Community Health Systems.
Community Health Systems purchased HMA in January 2014.
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At the time relevant to the lawsuit, between 2008 and 2009, the hospital was owned by HMA.
The lawsuit alleges that the hospital paid kickbacks to Clinica de la Mama, an obstetric clinic serving primarily undocumented Hispanic women. In return, the clinic referred pregnant women to HMA’s Walton Regional for deliveries, which were billed to Medicaid.
The kickbacks were disguised as payments for a variety of services allegedly provided by Clinica, according to the Department of Justice.
Although undocumented aliens are not eligible for regular Medicaid coverage, the Medicaid program provides coverage for emergency conditions, including childbirth, for undocumented aliens, according to authorities.
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The government intervened in the case against Walton Regional, as well as several other defendants, including Clinica de la Mama and four hospitals owned by Tenet Healthcare Corporation, according to the Justice Department. Litigation against the non-settling defendants is ongoing.
The claims resolved by the settlement are allegations, with no determination of liability, according to the DOJ.
As part of the settlement, HMA and Clearview will pay the state of Georgia an additional $396,770 to settle Georgia’s claims under the Georgia False Medicaid Claims Act.
Twitter: @SusanMorseHFN