Whistleblower and Health Associates Management Settle Lawsuits for $260 Million

Department of Justice settles suit filed by Goldberg Kohn Ltd.

David Chizewer and Matthew Organ of Goldberg Kohn Ltd., alleged in one of the lawsuits that Health Associates Management (HMA) has, for years, intentionally and systematically admitted to its hospitals emergency room patients who did not need to be admitted, and then charged the government for those unnecessary admissions.

“Our client had the integrity to come forward and stop that interference, and we are proud to represent him. We are grateful that the Department of Justice took our client’s allegations seriously, and diligently and skillfully prosecuted the case.”

The lawsuit were filed in Chicago by Chizewer and Organ on behalf of a well-respected emergency room physician under the qui tamor whistleblower provisions of the False Claims Act, which encourage 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, calling the False Claims Act “one of the most powerful tools” in the effort to combat healthcare fraud.

The United States joined the lawsuit, along with lawsuits filed by other whistleblowers, contending, among other things, that HMA pressured physicians to increase admissions without regard to medical necessity.

“Corporate interference with physician decision-making for the purpose of bolstering profits jeopardizes patient health at the expense of American taxpayers,” said Matthew Organ, a principal in Goldberg Kohn’s Litigation practice. “Our client had the integrity to come forward and stop that interference, and we are proud to represent him. We are grateful that the Department of Justice took our client’s allegations seriously, and diligently and skillfully prosecuted the case.”

“Billing for unnecessary hospital stays wastes federal dollars,” said Assistant Attorney General Hunt in a press statement.  “In addition, offering financial incentives to physicians in return for patient referrals undermines the integrity of our health care system.  Patients deserve the unfettered, independent judgment of their health care professionals.”

“The payment of kickbacks in exchange for medical referrals undermines the integrity of our healthcare system,” said U.S. Attorney Chapa Lopez in a press statement. “Today’s resolution should remind healthcare providers of their duty to comply with the law, and the heavy price to be paid for corrupt practices committed by their executives. Our Civil Division will continue to invest itself in the pursuit of health care providers who violate the law for personal gain.”

The government team was led by Department of Justice attorneys Marie Bonkowski and Laurie Oberembt. The lawsuit is captioned United States of America ex rel. Plantz, M.D., et al. v. Health Management Associates Inc., et al., No. 13 CV 1212 (N.D. Ill.). In 2014, the case was transferred to the federal district court in the District of Columbia, along with the other whistleblower suits, and was assigned case number 14 MC 00339.

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