Welcome!

News Feed Item

Grant & Eisenhofer Represents Whistleblowers in Nearly $100 Million Settlement With Community Health Systems, Resolving Claims that Medicare/Medicaid Payors Were Bilked by Excessive ER Admissions

Justice Department and multi-state AG settlement resolves alleged scheme of over-admitting patients at nearly 120 CHS hospitals across 20 states; whistleblowers include former ER physician in Philadelphia

WASHINGTON, Aug. 4, 2014 /PRNewswire/ -- In a major settlement for alleged health care fraud, law firm Grant & Eisenhofer P.A., working with the U.S. Justice Department and various states' attorneys general, has reached an agreement with Community Health Systems (NYSE: CYH) to resolve whistleblower lawsuits filed under federal and state false claims acts. The Franklin, Tenn.-based company, one of the nation's largest for-profit hospital chains, will pay over $97 Million to settle allegations that federal and state insurance plans were bilked by over-admissions for emergency rooms at nearly 120 CHS hospitals around the country, including ER facilities in Philadelphia, Las Vegas, Oklahoma City and elsewhere.

The global settlement resolves allegations in seven qui tam lawsuits brought in federal courts around the country, including one filed May 2011 in the U.S. District Court in Nashville: United States ex rel. Doghramji v. Community Health Systems Inc. Grant & Eisenhofer, along with law firms Cohen Millstein Sellers & Toll PLLC and Barrett, Johnston, Martin & Garrison LLC, represented three plaintiff-relators in the case, including Dr. James Doghramji, who served as an ER physician at Philadelphia's Chestnut Hill Hospital.

The lawsuits alleged that CHS engaged in a scheme to increase revenues by inappropriately increasing inpatient admissions to its hospitals from emergency room operations. Investigations revealed that the practice occurred in CHS hospitals in the following states: Tennessee, Alabama, Arizona, Arkansas, California, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Mississippi, New Jersey, New Mexico, North Carolina, Oklahoma, Pennsylvania, South Carolina, Texas and Virginia.  Whistleblowers – who included a number of former CHS ER staffers in addition to Dr. Doghramji – claimed that their hospitals routinely admitted patients who should have been released following their ER visits, and for whom the government's Medicare and Medicaid programs never should have been billed. 

Among the allegations in the 165-page relators' complaint: "To service the high debt accumulated by an aggressive business strategy of leveraged acquisitions, CHS embarked on a scheme to increase inpatient admissions from its ERs absent any corresponding change in the medical needs of the patients... The necessary and intended result of CHS's wrongful conduct has been a massive number of false and/or fraudulent claims by CHS hospitals across the country…"

In addition to very specific allegations about hospital practices, the Doghramji complaint alleged a statistical analysis that pin-pointed inpatient admission anomalies at over 70 CHS hospitals across the nation.

"The allegations supporting this lawsuit tell the story of a large publicly traded for-profit hospital chain gobbling up local community hospitals and running them with an eye toward financing their acquisitions by a scheme to bill the government for unnecessary medical services," said Reuben Guttman, a director at Grant & Eisenhofer who heads its Washington, D.C.-based False Claims Litigation Group.  Traci Buschner, Senior Counsel at G&E, led the case for the firm.

Mr. Guttman noted the serious patient safety concerns raised by the claims of this case: "The scheme that these whistleblowers brought to light defrauded the Medicare system and compromised patient safety by unnecessarily hospitalizing individuals at CHS hospitals nationwide.  Legitimate patients in need of proper medical care and attention surely suffered as a result of CHS resources being directed to tend to individuals who were filling beds solely to run up steep charges for the parent company."

Dave Garrison, partner at Barrett, Johnston, Martin & Garrison, stated: "Because of these brave individuals, the federal government has reached a historic settlement that will help ensure the integrity of Medicare and demonstrate that no company is above the law." 

Grant & Eisenhofer is one of the nation's leading litigation firms, with a major track record representing whistleblowers in cases involving abuses in the health care and pharmaceutical industries.   In the last two years, its False Claims Litigation Group has had unprecedented success representing lead whistleblowers in the government's $1.6 billion settlement with Abbott (2012); its $1.04 billion settlement with GlaxoSmithKline (2012); its $257 million settlement with Pfizer (Wyeth) (2013); and its $24.9 million dollar settlement with Amgen (2013).

About Grant & Eisenhofer
Grant & Eisenhofer P.A. represents plaintiffs in a wide range of complex financial litigation. G&E's clients include institutional investors, whistleblowers and other stakeholders in bankruptcy litigation, securities class actions, derivative lawsuits, consumer class actions, antitrust suits, and cases involving the False Claims Act. G&E has recovered more than $13 billion for investors in the last five years and has consistently been cited by RiskMetrics for securing the highest average investor recovery in securities class actions. Grant & Eisenhofer has been named one of the country's top plaintiffs' law firms by The National Law Journal for the past ten years. For more information, visit http://www.gelaw.com/

Contact:
Allan Ripp 212-262-7477 [email protected]
Elise Martin 302-622-7004 [email protected]

SOURCE Grant & Eisenhofer

More Stories By PR Newswire

Copyright © 2007 PR Newswire. All rights reserved. Republication or redistribution of PRNewswire content is expressly prohibited without the prior written consent of PRNewswire. PRNewswire shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon.

Latest Stories
"Software-defined storage is a big problem in this industry because so many people have different definitions as they see fit to use it," stated Peter McCallum, VP of Datacenter Solutions at FalconStor Software, in this SYS-CON.tv interview at 18th Cloud Expo, held June 7-9, 2016, at the Javits Center in New York City, NY.
As you move to the cloud, your network should be efficient, secure, and easy to manage. An enterprise adopting a hybrid or public cloud needs systems and tools that provide: Agility: ability to deliver applications and services faster, even in complex hybrid environments Easier manageability: enable reliable connectivity with complete oversight as the data center network evolves Greater efficiency: eliminate wasted effort while reducing errors and optimize asset utilization Security: implemen...
Data is the fuel that drives the machine learning algorithmic engines and ultimately provides the business value. In his session at Cloud Expo, Ed Featherston, a director and senior enterprise architect at Collaborative Consulting, discussed the key considerations around quality, volume, timeliness, and pedigree that must be dealt with in order to properly fuel that engine.
In his session at Cloud Expo, Alan Winters, U.S. Head of Business Development at MobiDev, presented a success story of an entrepreneur who has both suffered through and benefited from offshore development across multiple businesses: The smart choice, or how to select the right offshore development partner Warning signs, or how to minimize chances of making the wrong choice Collaboration, or how to establish the most effective work processes Budget control, or how to maximize project result...
"DivvyCloud as a company set out to help customers automate solutions to the most common cloud problems," noted Jeremy Snyder, VP of Business Development at DivvyCloud, in this SYS-CON.tv interview at 20th Cloud Expo, held June 6-8, 2017, at the Javits Center in New York City, NY.
CI/CD is conceptually straightforward, yet often technically intricate to implement since it requires time and opportunities to develop intimate understanding on not only DevOps processes and operations, but likely product integrations with multiple platforms. This session intends to bridge the gap by offering an intense learning experience while witnessing the processes and operations to build from zero to a simple, yet functional CI/CD pipeline integrated with Jenkins, Github, Docker and Azure...
"Our strategy is to focus on the hyperscale providers - AWS, Azure, and Google. Over the last year we saw that a lot of developers need to learn how to do their job in the cloud and we see this DevOps movement that we are catering to with our content," stated Alessandro Fasan, Head of Global Sales at Cloud Academy, in this SYS-CON.tv interview at 20th Cloud Expo, held June 6-8, 2017, at the Javits Center in New York City, NY.
"Akvelon is a software development company and we also provide consultancy services to folks who are looking to scale or accelerate their engineering roadmaps," explained Jeremiah Mothersell, Marketing Manager at Akvelon, in this SYS-CON.tv interview at 21st Cloud Expo, held Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA.
IoT is rapidly becoming mainstream as more and more investments are made into the platforms and technology. As this movement continues to expand and gain momentum it creates a massive wall of noise that can be difficult to sift through. Unfortunately, this inevitably makes IoT less approachable for people to get started with and can hamper efforts to integrate this key technology into your own portfolio. There are so many connected products already in place today with many hundreds more on the h...
As organizations shift towards IT-as-a-service models, the need for managing and protecting data residing across physical, virtual, and now cloud environments grows with it. Commvault can ensure protection, access and E-Discovery of your data – whether in a private cloud, a Service Provider delivered public cloud, or a hybrid cloud environment – across the heterogeneous enterprise. In his general session at 18th Cloud Expo, Randy De Meno, Chief Technologist - Windows Products and Microsoft Part...
DXWorldEXPO LLC announced today that ICC-USA, a computer systems integrator and server manufacturing company focused on developing products and product appliances, will exhibit at the 22nd International CloudEXPO | DXWorldEXPO. DXWordEXPO New York 2018, colocated with CloudEXPO New York 2018 will be held November 11-13, 2018, in New York City. ICC is a computer systems integrator and server manufacturing company focused on developing products and product appliances to meet a wide range of ...
Andi Mann, Chief Technology Advocate at Splunk, is an accomplished digital business executive with extensive global expertise as a strategist, technologist, innovator, marketer, and communicator. For over 30 years across five continents, he has built success with Fortune 500 corporations, vendors, governments, and as a leading research analyst and consultant.
JETRO showcased Japan Digital Transformation Pavilion at SYS-CON's 21st International Cloud Expo® at the Santa Clara Convention Center in Santa Clara, CA. The Japan External Trade Organization (JETRO) is a non-profit organization that provides business support services to companies expanding to Japan. With the support of JETRO's dedicated staff, clients can incorporate their business; receive visa, immigration, and HR support; find dedicated office space; identify local government subsidies; get...
René Bostic is the Technical VP of the IBM Cloud Unit in North America. Enjoying her career with IBM during the modern millennial technological era, she is an expert in cloud computing, DevOps and emerging cloud technologies such as Blockchain. Her strengths and core competencies include a proven record of accomplishments in consensus building at all levels to assess, plan, and implement enterprise and cloud computing solutions. René is a member of the Society of Women Engineers (SWE) and a m...
In this presentation, you will learn first hand what works and what doesn't while architecting and deploying OpenStack. Some of the topics will include:- best practices for creating repeatable deployments of OpenStack- multi-site considerations- how to customize OpenStack to integrate with your existing systems and security best practices.