Complaint Details Fraud Allegations Against Kalispell Regional Healthcare
Federal agencies have been investigating allegations of a widespread illegal kickback scheme conducted by Kalispell Regional Healthcare to boost revenues that were used to compensate physicians and executives far above market value, while knowingly defrauding the federal government, according to a 91-page complaint filed in U.S. District Court by the hospital’s physician network chief financial officer.
The allegations say numerous physicians have been improperly compensated based on incentivized referrals, for which the KRH system profits, as opposed to their productivity or services rendered. The scheme has enriched senior executives and specialist physicians, while negatively impacting patient care, the complaint alleges.
The goal of the money-for-referral scheme, the complaint alleges, was to increase the number of Medicare, Medicaid and other patients to KRH hospitals, labs, clinics, and specialists to increase revenues. Certain employees were then excessively compensated for their efforts to lock in patient referrals to KRH, which is Flathead County’s largest employer with more than 4,000 employees.
“At least since 2011, Kalispell Regional has engaged in a scheme to pay excessive compensation to certain employed physicians to reward or induce them to refer patients, including Medicare patients, to Kalispell Regional hospitals and clinics,” states the complaint.
Read more: https://flatheadbeacon.com/2018/07/03/complaint-details-fraud-allegations-kalispell-regional-healthcare/