Arent Fox Partner Linda Baumann Discusses Intermountain Stark Law/False Claims Act Settlement

Arent Fox Health Care partner Linda Baumann was quoted by Bloomberg BNA’s Health Care Fraud Report about Intermountain Healthcare’s settlement with the Justice Department.

The article reported that the Justice Department reached a deal with Intermountain after the government alleged violations of the Stark statute and the False Claims Act. The deal was worth $25.5 million, a very large amount for such a case. Nevertheless, the article noted that because Intermountain self-disclosed these issues to the government, penalties for the violations were not as steep as they could have been.

In reference to these violations — and the various doctors involved in the settlement — Ms. Baumann said that she “would not be surprised if [Intermountain] got a significant advantage by self-disclosing,” adding “we’re talking about a nine-year period for [over] 200 doctors.”

Ms. Baumann also noted the significance of the fact that there was no corporate integrity agreement (CIA) in the settlement: “It is important that the [Department of Health and Human Services’ Office of Inspector General] did not impose any compliance obligations, like a corporate integrity agreement, on Intermountain.” This is strong evidence that they must have demonstrated to the OIG in a very meaningful way the strength of their compliance program.”

The article also reported on the complexity of the settlement, and on the difficult issues that providers often face in dealing with compliance generally, and deciding whether to self-disclose. As Ms. Baumann noted, if the government were willing to provide more detailed information about the settlement, it could significantly enhance compliance. For example, “It would educate providers as to what they can and can’t do, and frankly, incentivize providers a little more to do self-disclosures if they knew how much less [Intermountain] paid than what they could have paid,” said Ms. Baumann.

To read the article, click here (subscription required).

Continue Reading