A multi-million euro comparison between Health Management Associates and the federal government closes a dark chapter in the last years of the hospital chain formerly based in Naples. The colony, she said, proves that this kind of behavior was happening everywhere with the HMA. Mike Mastej, of Naples, who worked for HMA until 2007 and oversaw the construction of the former HMA Hospital, now Physicians Regional – Collier Boulevard, said the colony was long overdue. “This agreement is the result of the FBI`s hard work and commitment to hold companies accountable for their role in fraud and abuse in the health care sector,” FBI Director Robert Johnson of the Department of Criminal Investigation said in a press release. The comparison includes a guilty plea to one count of conspiracy to commit health fraud by Carlisle HMA, who once operated Carlisle Regional Medical Center in Carlisle, Pennsylvania. The HMA transaction announced Tuesday contains a non-prosecution agreement in which the federal government agrees not to file a complaint against HMA. Schilling said the deal was not a surprise, as very few cases of health fraud include lawsuits. Other charges that will be resolved by the civil settlement are that between 2009 and 2012, two former HMA hospitals, Lancaster Regional Medical Center and the Heart of Lancaster Medical Center in Pennsylvania, billed federal health programs for services billed by doctors with whom the institutions had improper financial relations. These relationships are the result of excessive payments made by HMA to (1) a large group of physicians in exchange for two companies owned by the group and services purportedly provided by the group, and (2) from a local surgeon who exceeded the value of the services provided. The government said these agreements were structured in this way to hide payments to transfer patients. HMA has agreed to pay $55 million to the United States to resolve these civil charges. As part of the criminal decision, hmA entered into a three-year, non-criminal agreement with the Department of Justice`s criminal department under the “enterprise system of deception on the health programs of the Confederation, by illegitimately subjecting doctors who cared for HMA hospitals to illicit pressures and encouraging them to increase the number of patient admissions to emergency departments. , regardless of the medical necessity of the authorizations,” the Department of Justice said.
HMA also agreed to pay $216 million in a related civil transaction that dethrones the responsibility of filing false claims between 2008 and 2012 to increase hospital admissions for Medicare, Medicaid and TRICARE recipients, according to the comparison. The federal government states that hospitalization was not medically necessary and that patients should be cared for in a less expensive environment. “We are pleased to have reached the agreement so that we can now move forward without the burden or distraction of ongoing litigation,” he said. “As an organization, we strive to do our best to always comply with the law and manage our business with integrity, ethics and high standards of conduct in a very complex regulatory environment.” To induce patient transfers, Charlotte Regional provided a local medical group with free offices and staff, as well as direct payments, to cover overhead and administrative costs related to the management of a doctor at the hospital, according to the comparison. CHS said the agreement announced Tuesday closed the investigation into whether HMA and its affiliated hospitals billed Medicare, Medicaid and TRICARE for hospital admissions following emergency visits between January 2008 and December 2012, which should have been billed as outpatient or observation services.