Cornerstone Healthcare Group Holding Inc. and CHG Hospital Medical Center LLC. dba Cornerstone Hospital Medical Center have agreed to pay the United States $21,637,512 to resolve claims that the company improperly billed Medicare, announced US Attorney Alamdar S. Hamdani. Some of the alleged claims were submitted for unauthorized services, services not provided and services which were deemed so inadequate they were considered worthless. Cornerstone Medical Center was formerly a long-term acute care facility located in Houston that operated as a long-term care hospital. Cornerstone was in the business of providing extended medical and rehabilitative care to individuals who qualified as clinically complex and possessed multiple acute and/or chronic conditions. Through its subsidiaries, CHG Holding operated specialty hospitals throughout the United States, including Cornerstone Medical Center which is no longer in business.
The investigation began when a qui tam aka whistleblower lawsuit was filed under seal Sept. 28, 2018. The individual filing the suit worked at Cornerstone Medical Center long-term care facility. During the relator’s employment, they witnessed, among other things, unlicensed, unauthorized students of Drs. Jorge Guerrero, Joel Joselevitz and Joseph Varon rendering medical procedures. These unauthorized and improper services were fraudulently billed to Medicare. In addition, Cornerstone Medical Center submitted claims for payment for services certain treating physicians allegedly rendered. However, records showed those physicians were actually out of the country and could not have performed the services. Finally, the investigation concluded that from Jan. 1, 2012, through Dec. 31, 2018, Cornerstone Medical Center billed for services not supported by the patients’ diagnosis or medical records, and billed for services that were either not rendered or were so inadequate they were worthless (in some cases, resulting in harm to patients.) The claims for payment to Medicare for those services were deemed to be fraudulent and submitted in violation of federal law.
