Two whistleblowers claim Community Health Systems, based in Franklin, Tennessee, submitted hundreds of millions of dollars worth of false claims to the U.S. Department of Health and Human Services for federal incentive payments given for meaningful use of electronic health records (EHRs).
The lawsuit was unsealed by federal court in Miami recently. In it, plaintiffs claim CHS instructed its hospitals to submit attestations for incentive payments because they would be an important stream of revenue for the health system.
The whistleblowers worked for CHS as recently as December 2016, and claim the scheme resulted in CHS earning more than $450 million in EHR incentive payments between 2012 and 2015.
How the incentive payments work
HHS makes Medicare and Medicaid incentive payments to doctors and hospitals that show they make meaningful use of certified EHR technology as part of the Promoting Interoperability Program. To qualify for these incentive payments, hospitals and their caregivers must attest to their use of certified technology and must satisfy certain program objectives.
In this case, however CHS and its hospitals knowingly misrepresented their eligibility for subsidy payments.
While the federal government has not yet intervened in the lawsuit, it is still investigating the case and could very well decide to step in and continue the False Claims Act case on behalf of the whistleblowers. If the government finds evidence of wrongdoing and the case results in enforcement actions being taken against CHS, the whistleblowers could be eligible to receive substantial awards for their reporting.
For more information and guidance when starting a False Claims Act case, consult a knowledgeable whistleblower lawyer at Kardell Law Group.