Tuesday, July 22, 2008

KY3 offers more details on Cox settlement

KY3 has the government's version of the settlement it reached with Cox Health officials who had been accused of medicare fraud. A link to KY3's video report can also be found here:

The settlement agreement recites allegations that, beginning in January 1996, Cox entered into prohibited financial arrangements with physician group Ferrell-Duncan Clinic. Because those arrangements induced physicians to refer patients to Cox, they violated federal laws known as the Stark Law and the Anti-Kickback Statute.

“Our priority is protecting the patients,” (U. S. Attorney John) Wood said. “These laws are intended to ensure that physicians make referrals to health care facilities based on the best interest of their patients without being induced by payments from hospitals competing for their business. These laws also protect the integrity of the government-funded health care benefit programs.”

The settlement agreement also recites allegations that, from January 1997 through March 25, 2005, Cox submitted fraudulent Medicare cost reports. Because these reports employed an improper method of reporting its medical clinics’ overhead, they resulted in claims for non-reimbursable clinic costs.

Finally, the settlement agreement recites the government’s contention that, from January 1999 through December 2004, through entities controlled by Cox (Ozark Dialysis Services and Cox HPS of the Ozarks), Cox improperly billed for end stage renal disease treatments provided to patients. The United States alleges that these improper billings violated the False Claims Act, a law prohibiting the submission of false claims for Medicare payments.

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