William Beaumont Hospital Corporate Integrity Agreement

“This agreement is consistent with and will complement our current commitment to effective compliance policies and processes,” Fox said. “We will continue to work with HHS to ensure the highest level of compliance and transparency at all levels of the organization. Most importantly, we will continue to focus on our critical mission of providing compassionate and extraordinary care to our patients, families and the communities we serve. Anti-kickback status prohibits the supply, payment, demand or receipt of compensation for transfers of goods or services covered by Medicare, Medicaid and other federally funded programs. The Physician Self-Recommendation Act, commonly known as the Stark Act, prohibits a hospital from charging Medicare for certain services designated by physicians with whom the hospital has an unauthorized financial agreement, including payment of compensation above the fair value of services actually provided by the physician and the provision of free or underpaid office and rental staff in the market. Both the anti-kickback status and the Stark Act are designed to ensure that physicians` medical judgments are not affected by inappropriate financial incentives, but are based on the well-being of their patients. The transaction agreement also argues that WBH provided and billed some CT radiology services as hospital services, although the imaging centre does not meet regulatory requirements based on Medicare providers. Beaumont Health has agreed to pay an US$84.5 million transaction to the U.S. Department of Justice, the State of Michigan and four whistleblowers for violating federal laws that prevent hospitals from overcompensating doctors and making false allegations. The following day, August 3, Prime Healthcare Services, Inc., two of its subsidiaries and fourteen of its hospitals (Prime) entered into a $65 million agreement with Prime`s Chief Executive Officer with Prime`s Chief Executive Officer with DOJ to resolve allegations of poor coding and billing practices in hospitals. According to the DOJ`s allegations, hospitals knowingly violated the ACF by including patients who needed more cost-effective outpatient care (such as compliance care) and coded bills by encoding more expensive diagnoses than patients.