US Attorney David C. Weiss announced that ChristianaCare has paid $42.5 million to resolve allegations of healthcare fraud arising under the federal False Claims Act and the Delaware False Claims and Reporting Act. ChristianaCare operates three hospitals and numerous other healthcare facilities in northern Delaware and the surrounding area. The settlement amount has been allocated between the United States and the State of Delaware based on the value of the underlying healthcare claims. In a complaint filed under the whistleblower provisions of the False Claims Act in 2017, ChristianaCare’s former chief compliance officer alleged that ChristianaCare had provided illegal remuneration to non-employee neonatologists and surgeons in the form of services from ancillary support providers (including nurse practitioners, hospitalists, and physician assistants) to inpatients at ChristianaCare hospitals.
The lawsuit alleged that the services of the ancillary support providers impermissibly sought to induce those neonatologists and surgeons to refer their patients to ChristianaCare hospitals and created financial relationships between the non-employee providers and ChristianaCare. As a result, the complaint alleged, ChristianaCare’s claims to government-funded healthcare programs, including Medicare and Medicaid, for the care it provided to the referred patients during their hospitalization violated the federal Anti-Kickback Statute and the physician self-referral law, also known as the Stark Law. In 2020, after the conduct at issue in this case, the federal Centers for Medicare and Medicaid Services issued additional guidance, clarifying the billing and patient-referral rules surrounding services provided by hospitals during inpatient stays.
