Cookeville Hospital Submitted False TennCare Claims, U.S. Attorney Says

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Cookeville Regional Medical Center Authority has agreed to pay $4.1 million to settle allegations that it violated the False Claims Act, announced Don Cochran, United States Attorney for the Middle District of Tennessee.

This, according to a press release Cochran released this week.

The alleged conduct involved payments to physicians in violation of the Anti-Kickback Statute and Stark Law, the press release went on to say.

“Federal statutes exist to protect the well-being of patients and to prevent improper influence on patient care by providers,” the press release quoted U.S. Attorney Don Cochran as saying.

“The U.S. Attorney’s Office and our law enforcement partners will continue to aggressively enforce the laws designed to protect the patient and the integrity of federal healthcare programs.”

The settlement resolves allegations by the United States and State of Tennessee that from January 2012 through December 2017 Cookeville Regional Medical Center submitted false claims for payment to the Medicare program and to TennCare as a result of violations of the Federal Anti-Kickback Statute and the Stark Law. These violations related to financial arrangements between CRMC and physicians associated with its wholly owned subsidiary physician practice, CRMC MSO-Sub 1, Inc. d/b/a Tennessee Heart, the press release said.

Under the terms of the agreement, the United States will receive $3,647,155.00 and the State of Tennessee will receive $452,845.00, according to the press release.

“The Stark Law prohibits hospitals and physicians from entering into improper financial relationships that can disrupt the physician decision-making process,” said Derrick L. Jackson, Special Agent in Charge at the U.S. Department of Health and Human Services, Office of Inspector General in Atlanta.

“Our agency, working closely with our law enforcement partners, will continue to protect patients and the federal health care programs that serve them.”

“We are fortunate to have this strong relationship with our federal law enforcement partners, and continue to be diligent in pursuing false claim actions that have the potential to affect quality of our health care, in addition to costing consumers and taxpayers,” the press release quoted TBI Director David Rausch as saying.

The allegations resolved by the settlement were originally raised in a lawsuit filed against CRMC by a former employee who brought claims under the qui tam, or whistleblower, provisions of the FCA, which allow private citizens with knowledge of false claims to bring civil suits on behalf of the government and to share in any recovery. The whistleblower will receive $779,000 as his share of the settlement, the press release stated.

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Chris Butler is an investigative journalist at The Tennessee Star. Follow Chris on Facebook. Email tips to [email protected]
Photo “Cokeville Regional Medical Center” by Cookeville Regional Medical Center. 

 

 

 

 

 

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2 Thoughts to “Cookeville Hospital Submitted False TennCare Claims, U.S. Attorney Says”

  1. 83ragtop50

    Just another example of the disaster called TennCare. Medicaid in a bottomless pit into which taxpayer money is dumped.

  2. Randy

    I wonder what the cost share would be for the more than 7 million that TennCare was improperly billed by Cherokee Health if a whistleblower came forward?

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