Lafayette, La.-based Priority Hospital Group, three of its managed long-term care hospitals and a physician are facing allegations of violations of the False Claims Act tied to medically unnecessary care and improper patient referrals, according to a Jan. 21 news release from the Justice Department.
What happened?
- The civil complaint names Riverside Hospital and Riverside Hospital of Louisiana (doing business as Riverside Hospital); Post Acute Enterprises (doing business as Mid Jefferson Extended Care Hospital); and New Lifecare Hospital of North Louisiana (doing business as Ruston Regional Specialty Hospital).
- Federal prosecutors allege the hospitals held Medicare patients longer than medically necessary to maximize reimbursement and delayed appropriate discharges or transfers to lower levels of care.
- The complaint also alleges that Riverside Hospital paid a physician under a medical directorship and through other means to induce patient referrals, in violation of the Anti-Kickback Statute and Stark law.
- The case, filed under the qui tam provisions of the False Claims Act by a former employee, allows the U.S. to intervene and seek damages of up to three times the alleged loss, plus penalties.
