Infirmary Health System Accused of Fraud

Infirmary Health System Accused of Fraud

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Mobile, AL -

The U.S. Department of Justice claims doctors at Mobile's Infirmary Health System defrauded federal taxpayers a half-billion dollars. A lawsuit claims Medicare and Medicaid paid for unneeded testing at Infirmary facilities - testing ordered by Infirmary-affiliated doctors as part of a kick-back scheme.

The Infirmary Health System includes a hospital and a number of affiliated clinics.

The Justice Department  claims doctors at the Infirmary's  Diagnostic Physicians Group  received bonuses, essentially kick backs, for referring patients to Infirmary clinics for testing, some of which may not have been medically necessary.

A former Cardiologist in the system, Dr. Christian M. Heesch, claims he complained about the system in 2009 and was fired in 2011. He took legal action against the Infirmary. That lawsuit has now been taken over by the federal government. A whistle blower law will allow Heesch to collect damages if the suit is successful.

Many of the tests were covered  by Medicare and Medicaid. From 2004 through 2010, those federal health insurance programs paid at least $520 million in false claims, according to the allegations.

In that same time period, the complaint alleges that doctors with Diagnostics Physicians Group collected $18 million in bonuses.

Infirmary Health denies the claims. CEO Mark Nix in a statement to News-5's says "We believe the Clinic has provided services and compensated its physicians in full accordance with the law and that the Clinic acted in the best clinical interest of our patients. Tests performed at the Clinic were medically necessary to provide appropriate care for our patients…"

The charges allege that in some cases doctors falsified results of preliminary tests in order to get more advanced testing for which they received a bonus.

   

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