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Adventist Health to Pay $115 Million for False Claims Act Violations

Jaclyn Jaeger | September 22, 2015

Adventist Health System, a non-profit healthcare organization that operates hospitals and other health care facilities in 10 states, this week agreed to pay $115 million to the government to resolve allegations that it violated the False Claims Act by maintaining improper compensation arrangements with referring physicians and by miscoding claims. 

The settlement resolves allegations that Adventist submitted false claims to the Medicare and Medicaid programs for services rendered to patients referred by employed physicians who received bonuses based on a formula that improperly took into account the value of the physicians’ referrals to Adventist hospitals. Federal law restricts the financial relationships that hospitals and clinics may have with doctors who refer patients to them.

The settlement also resolves allegations that Adventist...

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