According to the DOJ, the settlement resolved allegations that Mercy provided compensation to six physicians that exceeded the fair market value of their services. The issues were self-disclosed to the government by Mercy, according to the DOJ.
“During an internal audit, Mercy Health learned that it made errors in the administration of a small number of physician arrangements,” said Nanette Bentley, a spokeswoman for Mercy in a statement responding to questions from the Springfield News-Sun. “Mercy Health promptly disclosed the administrative errors to the federal government, with which it cooperated fully, and is pleased to have resolved the matter.”
A news release from the DOJ related to the settlement said federal law restricts the financial relationships that hospitals may have with doctors who refer patients to them.
“When physicians are rewarded financially for referring patients to hospitals or other health care providers, it can affect their medical judgment, resulting in overutilization of services and higher health care costs,” said Chad Readler, acting assistant attorney and head of the Justice Department’s Civil Division.
“In addition to yielding a recovery for taxpayers, this settlement should deter similar conduct in the future and help make health care more affordable.”
Information from the DOJ shows the case was handled by the U.S. Attorney’s Office for the Southern District of Ohio, the Office of Inspector General of the Department of Health and Human Services and the Centers for Medicare and Medicaid Services. The claims settled by the agreement are allegations only and there has been no determination of liability, according to the DOJ.
Earlier this year, Mercy announced a proposed merger with Bon Secours Health System, a nonprofit Catholic health system. That company operates in Maryland, Virginia, South Carolina, Kentucky, Florida and New York. It owns, manages or maintains joint ventures for 20 hospitals and 27 post-acute care facilities or agencies, including skilled nursing facilities, home care and hospice services, and assisted living facilities.
The new combined entity would be one of the 20 largest health systems in the U.S. and the fifth largest Catholic health system with $8 billion in net operating revenue. It would employ 57,000 associates and more than 2,100 employed physicians and advanced practice clinicians. The deal is expected to be finalized by the end of this year.
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