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Irwin County Hospital to Pay $520,000 in Settlement

Our law firm was an integral part in successfully achieving a $520,000 settlement in a false claims act suit against the Hospital Authority of Irwin County and 9 doctors.

Just a few of the claims against the hospital and the doctors included:

“Each claim submitted to Medicare and Medicaid where no doctor was present for the examination, diagnosis, and/or treatment is false.”

“The Doctors have conspired with ICH to implement this practice of having one of the Doctors act as the on-call doctor while no doctors are present at ICH.”

“ICH creates false records that indicate that the physician with the standing order being applied was the admitting and ordering physician.”

“Relators were aware that this scheme has been perpetrated at ICH since before they were employed by ICH.”

“No matter what symptoms the patient might be exhibiting, ICH performs an OB ultrasound on every pregnant patient, without consulting him or obtaining his or any other doctor’s medical opinion for that particular patient.”

The lawsuit, filed on July 8, 2013 on behalf of Connie Brogdon and Summer Holland, X‐Ray technicians, formerly and currently employed by Irwin County Hospital, respectively, is pursuant to the qui tam provisions of the False Claims Act, 31 U.S.C. § 3729, et seq., and the Georgia False Medicaid Claims Act, O.C.G.A. § 49‐4‐168.1, et seq.   The lawsuit resolves claims that the Defendants knowingly submitted or caused to be submitted numerous false or fraudulent claims for payment or approval to the Medicare Program and the Georgia Medicaid Program (1) arising from referrals by Dr. Amin while ICH was providing remuneration to Dr. Amin under management services agreements dated July 31, 1996 and November 2010, neither of which was consistent with fair market value; (2) arising from referrals from Defendant Doctors and treatment provided by Defendant Doctors while Defendant ICH had entered into leases with said Defendant Doctors that were not memorialized in writing, all in violation of the Stark Law, the Anti‐Kickback Statute, and related state regulations and policies; and (3) for diagnostic imaging services that lacked the required level of supervision.

Federal and State False Claims Acts allow private citizens with insider knowledge of fraud, waste, and abuse to bring an action on behalf of the governments and to participate in the recovery of the stolen funds.

These statutes allow governments to recover three times the amount they were defrauded, in addition to civil penalties of $5,500 to $11,000 per false claim. Successful whistleblowers can receive between 15 and 30 percent of the governments’ recovery.

The Relators were represented by nationally‐recognized whistleblower attorneys, Mike Bothwell of the Bothwell Law Group and Brandon Hornsby of the Hornsby Law Group. The settlement was achieved through the coordinated efforts of a team of state and federal investigators and attorneys from Attorney General Sam Olen’s Medicaid Fraud Control Unit, the Civil Division of the United States Department of Justice, the United States Attorney for the Middle District of Georgia, and the Office of Investigations for the U.S. Department of Health and Human Services’ Office of Inspector General.   Remarking on the significance of this settlement, whistleblower attorney Mike Bothwell stated that, “The state and federal government worked well with the private whistleblowers to resolve serious health care and billing issues for rural Georgia residents. This public/private partnership brought needed oversight on rural care issues in Irwin County that will continue for years to come.”

The case is United States and State of Georgia ex rel. Brogdon and Holland v. Hospital Authority of Irwin County et al., Civil Action No. 7:13‐cv‐00097(HL) (M.D. Ga.).

For more information about FCA settlements and FCA experience contact us today.