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Hospital to Pay $85M to Partially Settle Whistleblower Case Over Medicare Fraud

Halifax Health has reached a tentative deal to pay $85 million dollars as part of a federal whistleblower case accusing the hospital of Medicare fraud and paying kickbacks to neurosurgeons and doctors. The lawsuit is .S. et al. v. Halifax Hospital Medical Center et al and was filed by hospital employee Elin Baklid-Kunz.

The deal was reached just as the case was about to go to trial. However, a second part of Baklid-Kunz’s case, accusing Halifax of increasing revenues by admitting patients who could have been discharged to stay overnight, is scheduled for trial this summer. Possible liability for that could reach $400 million.

Baklid-Kunz continues to work at Halifax Health. Previously she worked for years for them in financial and regulatory compliance. Now she is director of physician services. Baklid-Kunz filed her Qui Tam case under the False Claims Act and she is entitled to a percentage of what is recovered. According to the News-Journal Online, Baklid-Kunz and her lawyers will get $20.8 million.

The US Justice Department, who joined the case, prosecuted the hospital for “profit-sharing” plans that were not legal and involved neurosurgeons and cancer doctors. Under the Stark Law, hospitals are not allowed to bill Medicare for services if the doctors involved have a financial interest that is not proper. Physicians purportedly made referrals to the hospital that were not medically necessary and which were then processed via Medicare.

Medicare Fraud, Whistleblower Lawsuits
If you suspect Medicare fraud has been committed against the government, you may be able to file a whistleblower lawsuit. Not only can this stop the fraud from continuing but also you will be saving taxpayers from having to pay for the wrongdoing of others.

As a whistleblower you want to make sure that your rights are protected and that you receive everything you are owed. In Massachusetts, please contact our Boston Medicare fraud law firm to find out whether you should pursue a Qui Tam case.

Hospital Agrees To Settle Whistleblower Claims For $85 Million, Mondaq, March 19, 2014

Halifax Health settles fraud case, Orlando Sentinel, March 3, 2014


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Whistleblower Lawsuit Accuses Quest Diagnostics of Bilking Medicaid Program, Boston Injury Lawyer Blog, September 21, 2013