Condell Health Voluntarily Discloses Fraud and Will Pay $36 Million

On December 1, MarketWatch.com reported that Condell Health Network has agreed to pay the United States and the State of Illinois $36 million after voluntarily disclosing that its facility in Libertyville, IL, received improper Medicare and Medicaid payments after filing false claims for reimbursement.  The disclosures came in the midst of Condell’s acquisition by Advocate Health Care, which is now complete.

Through their cooperation, Condell avoided a government lawsuit under the False Claims Act that would have resulted in higher penalties for their violations. 

The settlement involved three fraudulent practices in the relationships between Condell and its physicians that took place from 2002 through 2007.  Condell: leased medical office space to physicians at below fair market value rates, which is a violation of federal laws and regulations governing Medicare and Medicaid reimbursement; improperly allowed physicians to “work off” loans the hospital gave to them through hourly rates above fair market value and activities that did not benefit the community; and extended loans without assessment of need that benefitted the physicians and doctors who received them, not the community.

The settlement also alleges that Condell gave incentive bonuses to its physician recruiters, and its financial support agreements forbid doctors from admitting privileges at any other hospitals.

“We commend Condell for bringing these practices to our attention. We expect health care providers to come forward when they discover issues that could rise to the level of fraud without waiting for us to catch up to them, and when they do so, they may well benefit,” said U.S. Attorney Fitzgerald. 

 

If you are witnessing fraud on the government, contact us by calling 800-377-1812 for strictly confidential advice from experienced counsel, with no fee obligation.