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Halifax Health Medicare Settlement Appears Near

Filed July 14th, 2014 Eric

A settlement to resolve a whistleblower lawsuit that has cost Halifax Health more than $109 million appears near according to an attorney involved in the case.
Halifax Health Chief Operating Officer Ann Martorano told the Daytona Beach News-Journal Halifax Health hopes to resolve the matter in the next week or so.
The lawsuit, which was filed in 2009, alleges that the 678-bed public hospital system overcharged Medicare for brief hospital stays from 2002 to 2013 and also maintaining illegal contracts with six cancer doctors and three neurosurgeons, the Daytona Beach News-Journal reported.
Multiple sealed documents were finally entered into the court record last week, but details about what information the documents exposed was not released. The Halifax Health Board of Commissioners held a special meeting Friday at 2:30 p.m. in Conference Room A in the France Tower at the hospital to discuss litigation.
The hospital has spent more than $24 million on its legal fees while continuing to deny any wrongdoing. In March, Halifax Health settled claims dealing with the physician contracts for $85 million “and agreed to submit to greater scrutiny by federal regulators for the next five years,” the Daytona Beach News-Journal reported. As part of the settlement, the hospital admitted that its contracts with the cancer doctors were in violation of the Stark Law, but denied any other liability in the case.

The Stark Law prohibits providers from paying doctors based on volume and referrals, according to the Daytona Beach News-Journal. The law is in place because the U.S. Department of Justice believes such contracts can lead to unneeded tests and treatment that increase the nation’s health care bill.

The amount of money the settlement will be for remains a up for debate. Experts for the whistleblower said the hospital overcharged Medicare $72.5 million. That amount could legally be tripled and additional penalties assessed under the False Claims Act
However, Judge Gregory A. Presnell did not agree with the whistleblower’s calculation. He ruled Halifax Health should only be forced to pay the difference between the inpatient and outpatient levels, the Daytona Beach News-Journal reported.
The two sides originally attempted to resolve the lawsuit through mediation in May but didn’t get close to reaching an agreement. A trial was set to begin in federal court in Orlando last week before it was postponed.

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