By Michelle Buteau
December 18, 2023
Source: WCVB
Photo Source: Unsplash,
BOSTON — Dallas-based Steward Health Care, which operates several facilities across Massachusetts, is being sued by the federal government over the alleged violation of the law and for allegedly submitting false claims to Medicare, according to the Department of Justice.
Acting U.S. Attorney for Massachusetts Joshua Levy announced Monday that his office filed the complaint in U.S. District Court in Massachusetts. He said the government's investigation was prompted by allegations filed in a previous whistleblower lawsuit.
In a statement, Steward said the whistleblower complaint was filed five years ago by "a former employee seeking to collect money." The company also claims that the Massachusetts Attorney General declined to pursue the case.
"We are extremely disappointed and surprised that the U.S. Attorney in Boston today filed a civil complaint alleging that a single contract that Steward entered into with a single physician violated a complex and highly technical law — the Stark Law — governing physician compensation," a Steward spokesperson wrote in a statement. "The lawsuit is without merit and a waste of taxpayer money, and suffers from clear and obvious legal defects that Steward expects to address soon through a motion to dismiss."
Levy's office said Steward's St. Elizabeth's Medical Center in Boston violated the physician self-referral law and submitted the false claims after recruiting a cardiac surgeon, Dr. Arvind Agnihotri, in 2012 to serve as chief of cardiac surgery at the hospital. From 2013 through 2022, Steward paid Agnihotri more than "fair market value" and incentives that took into account referrals to St. Elizabeth's, Levy's office said. The self-referral law is also known as the Stark Law.
Agnihotri was paid more than $4.86 million in incentives based on the referrals, and Levy's office said many violated the self-referral law.
St. Elizabeth's then submitted over 1,000 claims worth tens of millions of dollars to Medicare despite knowing that the claims were not eligible for payment, Levy's office said.
"Notably, the lawsuit does not allege that Steward submitted claims for any medical procedures that were unnecessary, not performed, or billed incorrectly. It does not allege that the physician’s employment contract influenced his clinical decision-making in any (way). And it does not allege any harm to patient safety," a Steward spokesperson wrote.
"The government’s complaint today alleges that in its drive to increase cardiac surgeries at SEMC, the defendants entered into improper compensation arrangements with a cardiac surgeon, and knowingly submitted false claims to Medicare," Levy said in a statement. "We are committed to enforcing the Stark Law, and protecting patients and the Medicare program from financial relationships that can corrupt clinical decision-making."
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