Catholic Medical Center has agreed to pay $3.8 million to settle claims it provided free call coverage to a cardiologist in exchange for patient referrals to the Manchester, N.H., hospital, according to federal officials.
“The cardiologist who received the free call coverage referred millions of dollars in medical procedures and services to CMC over the decade in which the free services were provided,” the Department of Justice said in a news release.
Because the hospital submitted claims for payment to Medicare, Medicaid, and other federal health care programs for the services referred by the cardiologist, the government alleged the claims were the result of unlawful kickbacks.
The settlement resolves allegations brought in a whistleblower lawsuit filed in 2018 by cardiologist David Goldberg, MD, who previously worked at Catholic Medical Center (CMC) and is represented by Douglas, Leonard & Garvey.
The news release did not name the cardiologist involved in the alleged kickback scheme but the recently unsealed lawsuit says CMC paid its cardiologists above market rates ($10,000 per weekend, $3,000 per night) to provide free coverage services for Mary-Claire Paicopolis, MD.
The lawsuit also claims Dr. Paicopolis insisted the hospital implant only Boston Scientific devices in her patients and that her preferred electrophysiologist use only its Rhythmia mapping system during ablation procedures. To keep CMC from objecting, the suit alleges Boston Scientific offered CMC early access to its Watchman left atrial appendage occluder and provided “unprecedented” support to a nonacademic community hospital site.
“It went back several years, and that and the other issues in the suit were strong motivators for Dr. Goldberg to try to rectify the situation and he deserves a lot of credit for having done so,” attorney Charles G. Douglas III told this news organization.
Dr. Goldberg will receive $570,000 of the $3.8 million settlement as well as $145,361 in expenses, attorney fees, and costs.
Although not addressed in the federal news release, the lawsuit also alleges that CMC staff manipulated mortality data by discharging patients from the ICU and then readmitting them to hospice with a new patient number, “thereby avoiding the need to claim a surgical mortality.”
The lawsuit also says CMC “created a practice of covering up medical errors” and detailed 12 patient deaths between 2012 and 2018, alleging that these deaths were the result of substandard care.
CMC spokesperson Lauren Collins-Cline said in an email that the call coverage arrangement is no longer in place and originated almost 15 years ago with the input of legal counsel in order to provide high-quality care for patients.
“While CMC vigorously disagrees with the government’s allegations that this arrangement violated federal law, we have agreed to settle in order to avoid long costly civil litigation,” she said.
As to the other claims in the complaint, Ms. Collins-Cline said they were investigated by the government and dismissed per the settlement agreement. “CMC holds itself to the highest ethical standards in patient care and business conduct. That’s embedded in our mission and will always remain our highest priority.”
Mr. Douglas, however, said the government retains the right to pursue other claims in the lawsuit in the future. “So, [the hospital] is a little more optimistic than the reality of what the government agrees is the situation.”
A version of this article first appeared on Medscape.com.