Akron General Health System (AGHS), a hospital system in Ohio owned by the Cleveland Clinic Foundation, reached a civil settlement and agreed to pay $21 million for allegedly committing healthcare fraud by violating the False Claims Act.
AGHS is accused of unlawfully paying physician groups in excess of market value to secure patient referrals, then submitting Medicare claims for services issued to the illegally referred patients.
Under the Anti-Kickback Statute, paying for referrals as part of a federal healthcare program is illegal. The statute prohibits soliciting, offering, or paying to secure referrals of any services covered by Medicare, Medicaid, and any other federally funded healthcare program.
Source: $21M Settlement Resolves Healthcare Fraud Accusations for OH System / Revcycle Intelligence