Mercy Health and Clinic Settle False Medicare Claims for $5.5M; Whistleblower to Get $825K

Mercy Health Springfield Communities and Mercy Clinic Springfield Communities, formerly St. John’s Health System and St. John’s Clinic, respectively, have agreed to pay $5.5 million to resolve allegations that they knowingly submitted or caused the submission of false claims to federal health care program Medicare, the U.S. Department of Justice announced yesterday.

The settlement resolved allegations that the defendants submitted false claims to the Medicare program for services rendered to patients referred by physicians who received bonuses based on a formula that improperly took into account the value of the physicians’ referrals of patients to the clinic.  Federal law restricts the financial relationships that hospitals and clinics may have with doctors who refer patients to them.

The allegations settled today arose from a lawsuit filed by a whistleblower, Dr. Jean Moore, a physician who is employed by one of the defendants, under the qui tam provisions of the False Claims Act.  Under the act, private citizens can bring suit on behalf of the government for false claims and share in any recovery.  Dr. Moore will receive $825,000 from the recovery announced today.

The Chanler Group, in association with the Hirst Law Group, represents whistleblowers who take action under the False Claims Act to report fraud committed against the federal and state governments.  We have years of experience representing whistleblower clients who expose every kind of fraud against the government, including health care fraud, contract fraud, and tax fraud.  Read more about our expertise in False Claims Act cases and how you can take action.