Attorney General Olens announces settlement with Columbus Regional Hospital System to resolve overbilling and kickback allegations
Attorney General Sam Olens announced today that Georgia has reached a civil settlement agreement resolving allegations of Georgia False Medicaid Claims Act violations with Columbus Regional Hospital System (CHRS), The Medical Center (TMC), including TMC d/b/a John B. Amos Cancer Center (JBACC), Columbus Regional Oncology Treatment Center (CROTC), and Regional Oncology, LLC. CRHS, a non-profit health care system, owns and operates TMC, an acute care hospital in Columbus, Georgia, and TMC’s cancer center JBACC. Regional Oncology is a medical partnership employing all of the medical oncologists providing services of JBACC.
The defendants have agreed to pay Georgia and the United States $25,000,000, and will pay an additional $10,000,000 if certain financial conditions are met. The settlement resolves allegations that the defendants submitted claims to the State of Georgia for evaluation and management services billed at higher levels than supported by documentation, for radiation therapy that did not qualify as such, and for claims submitted in violation of Medicaid rules prohibiting the payment of remuneration in return for referral of Medicaid patients.
Georgia also reached a civil resolution with Dr. Andrew Pippas, a medical oncologist employed by CRHS who also serves as a Medical Director at JBACC. Under the agreement, Dr. Pippas will pay Georgia and the United States $425,000 to settle allegations that Dr. Pippas received improper salary and medical directorship payments from CRHS resulting in the illegal submission of claims by CRHS to Medicare and Medicaid.
“Cancer patients are among those most in need of a doctor’s earnest and unbiased medical advice,” said Attorney General Olens. “Medical providers must ensure that they do not solicit, offer, or accept payments based on their referral of patients. My office is not only committed to ensuring that Georgia Medicaid members receive quality medical care, but also that Georgia taxpayers receive what they are paying for. It should go without saying that when treating any patient, providers may only bill for services actually performed.”
The case began with a lawsuit filed May 8, 2012 by Richard Barker in the Middle District of Georgia under the whistleblower provisions of the federal False Claims Act and the Georgia False Medicaid Claims Act, which allow private citizens to bring civil actions on behalf of the government and also to share in any recovery obtained. This case is captioned United States and State of Georgia ex rel. Barker v. Columbus Regional Hospital System, et al., No. 4:12-cv-108 (M.D.Ga.) (“Barker I”). On December 29, 2014, the Relator filed another case, United States and State of Georgia ex rel. Barker v. Columbus Regional Hospital System, et al., No. 4:14-cv-304 (M.D.Ga.) (“Barker II”). The settlement covers claims alleged in both suits.
The claims settled in the civil settlement agreement are allegations only, and there has been no determination of liability.
The State of Georgia was represented by Assistant Attorney General Kevin Bradberry of the Georgia Medicaid Fraud Control Unit. These matters were settled in coordination with the United States Attorney’s Office for the Middle District of Georgia, the Commercial Litigation Branch of the United States Department of Justice’s Civil Division, the Department of Health and Human Services Office of the Inspector General, and other federal agencies.