|[August 04, 2014]
Community Health Systems to Pay $98 Million to Settle Charges of Submitting False Medicare and Medicaid Claims by Systematically Over-admitting Patients
WASHINGTON --(Business Wire)--
Community Health Systems, Inc. (CHS) has agreed to pay over $98 million
to resolve allegations that it overbilled the federal Medicare and
Medicaid systems by unnecessarily admitting patients to more than 100 of
its hospitals across the country. The settlement was announced today by
the U.S. Department of Justice.
Cohen Milstein Sellers & Toll PLLC, along with co-counsel Grant &
Eisenhofer and Barrett, Johnson, Martin & Garrison, represented
plaintiff-relators Dr. James Doghramji and Sheree Cook in their False
Claims Act lawsuit against CHS, one of seven lawsuits resolved by
today's settlement. Dr. Doghramji has served as an emergency room
physician at Philadelphia's Chestnut Hill Hospital and Cook worked as a
nurse at Heritage Medical Center in Shelbyville, Tenn. In May 2011, they
filed United States ex rel. Doghramji v. Community Health Systems Inc.
in the U.S. District Court in Nashville, Tenn. The complaint alleged
that CHS routinely admitted patients whose conditions were not severe
enough to justify admission, and then billed Medicare and Medicaid for
In addition to specific allegations about CHS' admission practices, Dr.
Doghramji and Cook also provided a comprehensive statistical analysis
showing admission rates that were significantly higher than expected at
more than 70 CHS hospitals nationwide.
"CHS unnecessarily hospitalized patients so that it could make more
money through larger Medicare and Medicaid reimbursements. This
settlement sends an important message that jeopardizing patient safety
in order to increase profits will not be tolerated," said plaintiffs'
counsel David Young (News - Alert), who along with attorney Kit Pierson led the case
for Cohen Milstein.
The False Claims Act is a federal law that imposes a liability on
persons and companies who attempt to defraud government programs.
Typically, this activity comes to light and a lawsuit is initiated
through whistleblowers who are allowed to file actions against these
parties on behalf of the government. Those filing under the Act stand to
receive a portion of any recovered damages. Cohen Milstein's
Whistleblower/False Claims Act Practice Group has decades of combined
experience successfully pursuing whistleblower cases under federal and
state law in industries that transact business with the government, such
as health care, pharmaceuticals, banking, defense, and importing. The
practice group also has extensive experience in addressing the
employment-related issues that commonly arise in whistleblower cases.
Founded in 1969, Cohen Milstein Sellers & Toll PLLC is a national leader
in plaintiff class action lawsuits and litigation. As one of the premier
firms in the nation handling major complex cases, including those
involving the False Claims Act, Cohen Milstein, with 80 attorneys, has
offices in Washington, D.C., New York, Philadelphia, Chicago, and Palm
Beach Gardens, Fla. For more information, visit http://www.cohenmilstein.com
or call (202) 408-4600.
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