Hospital Fails To Thwart Medicare Claims Lawsuit

     (CN) – The government can sue Halifax Hospital Medical Center for submitting fraudulent billing to Medicare, a federal judge ruled.

     The United States and Elin Baklind-Kunz, director of physician services for Halifax sued Halifax Hospital Medical Center and Halifax staffing Inc. under the False Claims Act.
     Baklind-Kunz says Halifax “admitted thousands of patients” even though they did not need inpatient medical assistance, so Halifax could fraudulently bill Medicare for services that were not needed, according to the ruling. She also claimed Halifax gave kickbacks to physicians.
     Halifax filed a motion to dismiss under the Eleventh Amendment immunity that limits the jurisdiction of the federal courts, and claiming that Baklind-Kunz publicly disclosed information before filing the complaint and failed to state a claim under the False Claims Act, the Stark Amendment and the Anti-Kickback Act, all of which were denied.
     Regarding the Eleventh Amendment, Judge Gregory Presnell says, “Halifax points to a number of examples of its treatment under state law, but none of them are particularly helpful to Halifax’s position.”
     Halifax claims because it received an information request from the Department of Justice regarding the intake of patients’ medical necessities that Baklind-Kunz publicly disclosed information in the suit before it was filed.
     “Halifax also makes no effort to show that the information request or the settlement announcement actually disclosed anything at all, much less that either disclosed any information that formed part of the basis of this case,” Judge Presnell concluded.
     Halifax then asserted that Baklind-Kunz failed to state a claim because she did not support her allegations with billing or payment records and only submitted internal audits with the complaint.
     Judge Presnell found that the audits were sufficient, as they revealed that inpatients’ records stated the patients did not meet the criteria for inpatient status. a
     Regarding Baklind-Kunz’s alleged violations of the Stark Amendment and the Anti-Kickback Act, Judge Presnell wrote, “These assertions do not merit extended discussion.”

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