Community Health Systems will pay $97,257,000.00 to settle whistleblower lawsuits unsealed in federal courts across the country.
Federal officials alleged CHS routinely admitted Medicare patients who presented at their hospitals’ emergency rooms with conditions that did not require admissions so that it could bill Medicare at higher inpatient rates, rather than less expensive outpatient rates.
To drive these valuable inpatient admissions, CHS established benchmarks for the percentage of patients, particularly those over 65, who should be admitted from the emergency room, in a scheme intended to improve its profitability, and without regard to medical necessity or patient safety.
How did these creeps make employees cooperate with their fraud?
CHS enforced those benchmarks by incentivizing and pressuring emergency department physicians and administrators to meet them. Physicians and administrators who failed to meet CHS’s benchmarks were threatened with termination, and some in fact were fired.
Seven separate whistleblower lawsuits filed against CHS and some of its subsidiaries were resolved with the settlement…
Each of them observed the same practices being directed from CHS’s corporate offices, which practices they felt violated the federal and/or state False Claims…
The whistleblowers brought their claims against CHS under the False Claims Acts, which encourages private citizens to report fraud against the government by allowing them to sue on behalf of the government and receive a share of any recovery.
The False Claims Act also allows the government to join and prosecute such lawsuits, as the Department of Justice did in this case.
We all know how phony most whistleblower “protection” is in practice. More realistic, the False Claims act says – hey – you’re gonna be screwed when you blow the whistle on the crooks you work for. If you have access to real evidence, don’t worry about saving your job. Take a percentage of the settlement with the government and retire!
CHS is one of the largest for‐profit hospital chains in the nation, with 208 hospitals in 29 states.
And, of course, they’re still in business. No one at the top has been indicted for a crime. AFAICS, the Board of Directors hasn’t peeped about the enterprise they oversee being caught defrauding American taxpayers.