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Kentucky Hospital to Pay Record Health Care Fraud Settlement

May 29, 2014 DBL Law

On May 28, 2014, King’s Daughters Medical Center in Ashland, Kentucky, entered into a civil settlement with the Federal government and the Commonwealth of Kentucky in the amount of $40.9 million. This represents the largest health care fraud settlement involving a hospital in the history of the Eastern District of Kentucky.

King’s Daughters entered into the settlement to resolve allegations that it had performed heart procedures on patients who did not medically need the procedures, in violation of the False Claims Act.

The government alleged that, over a 5-year period, KDMC billed for numerous unnecessary coronary stents and catheterizations performed by King’s Daughters physicians. It was alleged that the physicians falsified medical records in order to justify the procedures. The settlement also resolved allegations that King’s Daughters violated the Stark Law by improperly compensating the physicians. King’s Daughters did not admit any wrongdoing in connection with the settlement.

King’s Daughters also entered into a Corporate Integrity Agreement, which will be in place for five years and which requires King’s Daughters to undertake substantial internal compliance reforms, and commit to a third-party review of its claims to Federal health care programs for the next 5 years.

Out of the settlement payment, the Commonwealth of Kentucky will receive over $1 million, which represents its share of recovered Medicaid funds. Overall, the settlement amount represents roughly two times the amount of money King’s Daughters received as a result of the alleged fraudulent billing for unnecessary services.

The law firm of Dressman Benzinger LaVelle has offices in Cincinnati, Ohio, Crestview Hills, Kentucky, and Louisville, Kentucky.

 

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