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Indiana Health System Must Face DOJ’s Referral Fraud Claims

Oct. 21, 2021, 3:59 PM

The U.S. government adequately alleged that Indiana-based Community Health Network Inc. violated the False Claims Act by engaging in a scheme to bill Medicare for physician services at a rate that exceeded fair market value, a district court said.

The government says Community improperly billed Medicare for services provided by hundreds of physicians paid salaries that were significantly higher than what they received in their own practices, in order to secure patient referrals.

The complaint has numerous allegations Community determined physician compensation in a way that considered the volume or value of referrals, Judge Richard L. Young of the U.S. ...

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