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
A strange thing is happening along the way to the Internet of Things, namely far too many devices to work with and manage. It has become clear that we'll need much higher efficiency user experiences that can allow us to more easily and scalably work with the thousands of devices that will soon be in each of our lives. Enter the conversational interface revolution, combining bots we can literally talk with, gesture to, and even direct with our thoughts, with embedded artificial intelligence, whic...
SYS-CON Events announced today that Cloudistics, an on-premises cloud computing company, has been named “Bronze Sponsor” of SYS-CON's 20th International Cloud Expo®, which will take place on June 6-8, 2017, at the Javits Center in New York City, NY. Cloudistics delivers a complete public cloud experience with composable on-premises infrastructures to medium and large enterprises. Its software-defined technology natively converges network, storage, compute, virtualization, and management into a ...
Every successful software product evolves from an idea to an enterprise system. Notably, the same way is passed by the product owner's company. In his session at 20th Cloud Expo, Oleg Lola, CEO of MobiDev, will provide a generalized overview of the evolution of a software product, the product owner, the needs that arise at various stages of this process, and the value brought by a software development partner to the product owner as a response to these needs.
SYS-CON Events announced today that delaPlex will exhibit at SYS-CON's @ThingsExpo, which will take place on June 6-8, 2017, at the Javits Center in New York City, NY. delaPlex pioneered Software Development as a Service (SDaaS), which provides scalable resources to build, test, and deploy software. It’s a fast and more reliable way to develop a new product or expand your in-house team.
SYS-CON Events announced today that Tappest will exhibit MooseFS at SYS-CON's 20th International Cloud Expo®, which will take place on June 6-8, 2017, at the Javits Center in New York City, NY. MooseFS is a breakthrough concept in the storage industry. It allows you to secure stored data with either duplication or erasure coding using any server. The newest – 4.0 version of the software enables users to maintain the redundancy level with even 50% less hard drive space required. The software func...
New competitors, disruptive technologies, and growing expectations are pushing every business to both adopt and deliver new digital services. This ‘Digital Transformation’ demands rapid delivery and continuous iteration of new competitive services via multiple channels, which in turn demands new service delivery techniques – including DevOps. In this power panel at @DevOpsSummit 20th Cloud Expo, moderated by DevOps Conference Co-Chair Andi Mann, panelists will examine how DevOps helps to meet th...
Most technology leaders, contemporary and from the hardware era, are reshaping their businesses to do software in the hope of capturing value in IoT. Although IoT is relatively new in the market, it has already gone through many promotional terms such as IoE, IoX, SDX, Edge/Fog, Mist Compute, etc. Ultimately, irrespective of the name, it is about deriving value from independent software assets participating in an ecosystem as one comprehensive solution.
SYS-CON Events announced today that EARP will exhibit at SYS-CON's 20th International Cloud Expo®, which will take place on June 6-8, 2017, at the Javits Center in New York City, NY. "We are a software house, so we perfectly understand challenges that other software houses face in their projects. We can augment a team, that will work with the same standards and processes as our partners' internal teams. Our teams will deliver the same quality within the required time and budget just as our partn...
As DevOps methodologies expand their reach across the enterprise, organizations face the daunting challenge of adapting related cloud strategies to ensure optimal alignment, from managing complexity to ensuring proper governance. How can culture, automation, legacy apps and even budget be reexamined to enable this ongoing shift within the modern software factory?
SYS-CON Events announced today that A&I Solutions has been named “Bronze Sponsor” of SYS-CON's 20th International Cloud Expo®, which will take place on June 6-8, 2017, at the Javits Center in New York City, NY. Founded in 1999, A&I Solutions is a leading information technology (IT) software and services provider focusing on best-in-class enterprise solutions. By partnering with industry leaders in technology, A&I assures customers high performance levels across all IT environments including: mai...
With major technology companies and startups seriously embracing Cloud strategies, now is the perfect time to attend @CloudExpo | @ThingsExpo, June 6-8, 2017, at the Javits Center in New York City, NY and October 31 - November 2, 2017, Santa Clara Convention Center, CA. Learn what is going on, contribute to the discussions, and ensure that your enterprise is on the right path to Digital Transformation.
In his keynote at @ThingsExpo, Chris Matthieu, Director of IoT Engineering at Citrix and co-founder and CTO of Octoblu, focused on building an IoT platform and company. He provided a behind-the-scenes look at Octoblu’s platform, business, and pivots along the way (including the Citrix acquisition of Octoblu).
SYS-CON Events announced today that Systena America will exhibit at SYS-CON's 20th International Cloud Expo®, which will take place on June 6-8, 2017, at the Javits Center in New York City, NY. Systena Group has been in business for various software development and verification in Japan, US, ASEAN, and China by utilizing the knowledge we gained from all types of device development for various industries including smartphones (Android/iOS), wireless communication, security technology and IoT serv...
SYS-CON Events announced today that Outscale will exhibit at SYS-CON's 20th International Cloud Expo®, which will take place on June 6-8, 2017, at the Javits Center in New York City, NY. Outscale's technology makes an automated and adaptable Cloud available to businesses, supporting them in the most complex IT projects while controlling their operational aspects. You boost your IT infrastructure's reactivity, with request responses that only take a few seconds.
DevOps at Cloud Expo – being held October 31 - November 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA – announces that its Call for Papers is open. Born out of proven success in agile development, cloud computing, and process automation, DevOps is a macro trend you cannot afford to miss. From showcase success stories from early adopters and web-scale businesses, DevOps is expanding to organizations of all sizes, including the world's largest enterprises – and delivering real r...