Four Houston-area hospitals will pay $8.6 million to settle allegations they took kickbacks from ambulance companies in exchange for rights to the hospitals' more lucrative Medicare and Medicaid transport referrals, the Department of Justice announced.
The hospitals are all affiliated with the Nashville-based company Hospital Corp. of America, also known as HCA. They include Bayshore Medical Center, Clear Lake Regional Medical Center, West Houston Medical Center and East Houston Regional Medical Center.
The Anti-Kickback Statute stipulates that offering, paying, soliciting or receiving remuneration in order to cause referrals of items or services covered by federal healthcare programs is illegal. The settlement made with HCA resolves allegations that patients at the four hospitals got free or highly discounted ambulance transports from certain ambulance companies. In return, the hospitals referred lucrative Medicare and Medicaid business to those companies.
"If not for this kickback arrangement, the four hospitals would have been financially responsible for the patient transports at significantly higher rates," the DOJ said.
Since Medicaid is jointly funded by the state and federal government, the state paid some of the Medicaid claims that arose from the fraudulent arrangement, so the settlement includes more than $300,000 for the state of Texas.
The settlement arose from two whistleblower lawsuits.