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Press Release

ChristianaCare Pays $42.5 Million To Resolve Health Care Fraud Allegations

For Immediate Release
U.S. Attorney's Office, District of Delaware

WILMINGTON, Del. – U.S. Attorney David C. Weiss announced today that ChristianaCare has paid $42.5 million to resolve allegations of health care fraud arising under the federal False Claims Act and the Delaware False Claims and Reporting Act.  ChristianaCare operates three hospitals and numerous other healthcare facilities in northern Delaware and the surrounding area.  The settlement amount has been allocated between the United States and the State of Delaware based on the value of the underlying healthcare claims.

In a complaint filed under the whistleblower provisions of the False Claims Act in 2017, ChristianaCare’s former chief compliance officer alleged that ChristianaCare had provided illegal remuneration to non-employee neonatologists and surgeons in the form of services from ancillary support providers (including nurse practitioners, hospitalists, and physician assistants) to inpatients at ChristianaCare hospitals.  The lawsuit alleged that the services of the ancillary support providers impermissibly sought to induce those neonatologists and surgeons to refer their patients to ChristianaCare hospitals and created financial relationships between the non-employee providers and ChristianaCare.  As a result, the complaint alleged, ChristianaCare’s claims to government-funded healthcare programs, including Medicare and Medicaid, for the care it provided to the referred patients during their hospitalization violated the federal Anti-Kickback Statute and the physician self-referral law, also known as the Stark Law.  In 2020, after the conduct at issue in this case, the federal Centers for Medicare and Medicaid Services issued additional guidance, clarifying the billing and patient-referral rules surrounding services provided by hospitals during inpatient stays. 

“The prohibitions on kickbacks and self-referrals in federal healthcare programs are designed to ensure that the medical decisions of healthcare providers are driven by what is in the best interest of patient care, not provider profit,” said U.S. Attorney Weiss.  “That is true regardless of who provides the care, whether it is a solo practitioner or the largest healthcare system.  My office will continue to vigorously enforce these prohibitions so that Delawareans can receive the care that is appropriate to their medical needs.” 

A whistleblower suit, or qui tam action, under the False Claims Act, is commenced by an individual, known as a “relator,” filing a complaint under seal in the U.S. District Court, and providing a copy of the complaint and other evidence to the local U.S. Attorney.  The United States then has an opportunity to investigate the claims.  The False Claims Act provides the whistleblower with a share of the government’s recovery.        

The claims resolved by the settlement are allegations only and there has been no determination of liability.  Assistant U.S. Attorney Dylan J. Steinberg represented the United States in this matter.

Related court documents and information from the civil lawsuit are on PACER by searching for Case No. 1:17-cv-419-RGA.

Updated January 4, 2024

Topic
Health Care Fraud