Livingston Regional Hospital, LLC, of Tennessee has agreed to settle a False Claims Act case brought against it in federal court. It will resolve the allegations for $784,000. The hospital is owned by LifePoint Health, Inc., which operates hospitals across the U.S.
According to the U.S. Attorney for the Middle District of Tennessee, two former employees filed suit against Livingston Regional Hospital under the qui tam provision of the False Claims Act. Their lawsuit was later joined by the government.
The government alleged that Livingston Regional Hospital violated the False Claims Act by knowingly billing Medicare Part A for inpatient psychiatric care that it knew was not medically necessary. The false billings allegedly occurred between July 9, 2015, and October 31, 2015.
According to a spokesperson for Livingston Regional Hospital, the doctor responsible for providing the questionably necessary services is no longer with the hospital.
"We have been fully cooperative with the government in the resolution of this matter, and have taken appropriate measures to correct these issues moving forward. While we regret this happened, this situation in no way impacts our commitment to providing the best possible care to our patients," said the spokesperson.
When private citizens learn of possible fraud, waste or abuse against the government, they can file a qui tam suit under the False Claims Act. When the suit is successful, they can receive a substantial portion of the ultimate recovery as a reward.
In this case, the two former employees will share in an award of $156,800.
The allegations against Livingston Regional Hospital were investigated by the U.S. Department of Health and Human Services Office of Inspector General and the U.S. Attorney's Office for the Middle District of Tennessee. The settlement of the case was done without determining liability, so the claims are still considered mere allegations.
If you work in healthcare or any area involving government contracts, you could be rewarded for blowing the whistle on fraud, waste or abuse. Before filing any complaint, however, discuss your concerns with an attorney familiar with the False Claims Act and other whistleblowing statutes. Your lawyer can help ensure you receive any award due to you while working to prevent retaliation by your employer.