KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Florida Hospital To Pay $1M Settlement In False Claims Case

The settlement comes in what has been a closely watched Medicare overbilling case filed against Halifax Hospital. The Department of Justice must still sign off on the settlement. Advocate Health and Hospitals Corp. swatted away a class-action suit over last summer's data breach, but more are pending. Also in the news, a possible health worker strike in New York, and a North Carolina mayor walks to Washington to focus attention on the difficulties of rural hospitals.  

Modern Healthcare: Halifax Health To Pay $1M Settlement In Widely Watched False Claims Case
One of the most widely watched False Claims Act cases filed against a hospital is quietly approaching an end—Florida's Halifax Health is preparing to pay $1 million to settle an alleged $73 million Medicare overbilling case. Maximum damages in the trial, which had been scheduled to begin July 8, could have exceeded $200 million, which would have come on top of an $85 million settlement that the public health system in Daytona Beach, Fla., paid out in March to settle the first half of the case. The $1 million settlement won't become official until the Justice Department signs off on it this month, court records say. The False Claims Act makes it illegal for hospitals to submit inaccurate bills to Medicare. However, Presnell ruled July 1 (PDF) that it doesn't necessarily trigger the False Claims Act to bill Medicare for cases in which the medical record lacks “enough information to jusify admission” for inpatient care (Carlson, 7/14).

Modern Healthcare: Health System Beats Second Class Action Suit, Faces Others Over 2013 Data Breach
Advocate Health and Hospitals Corp. has now gone two for two in swatting away class-action lawsuits stemming from last summer's massive data breach involving more than 4 million of its patient records. Its legal challenges on this matter aren't over yet, however. Several other cases are pending. Kane County (Ill.) Circuit Court Judge James Murphy last week dismissed with prejudice a class-action suit in Matias Maglio et al., vs Advocate, citing the plaintiffs' lack of legal standing and failure to prove actual damages among other rationales in a three-page ruling in favor of the 10-hospital Advocate system. Advocate is based in the Chicago suburb of Downer's Grove, Ill. (7/14).

The Wall Street Journal: Health-Care Workers Eye One-Day Strike
About 70,000 New York City area nurses and other health-care workers are poised to authorize a one-day strike that would take place July 31. Negotiations over a new contract happen every three to four years, but now both union and hospital leaders are grappling with a new issue: an industrywide shift away from hospitals toward outpatient clinics (Krusisto, 7/14).

The Wall Street Journal’s Washington Wire: Small-Town Mayor Begins 273-Mile Walk To Washington
A small-town Republican mayor set out Monday on a 273-mile walk to Washington, D.C., to draw attention to the plight of rural hospitals. Mayor Adam O’Neal is fighting the recent closure of Pungo Vidant Hospital, the biggest employer in his coastal town of Belhaven, N.C. (pop. 1,700). The hospital’s situation was profiled in an article in The Wall Street Journal in May (Bauerlein, 7/14).

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