Jackson Purchase Medical Center Agrees To Pay $850,343.84 To Settle False Medicare Billings

LOUISVILLE, Ky. – PineLake Regional Hospital, LLC doing business as Jackson Purchase Medical Center (JPMC), has voluntarily entered into a settlement with the United States of America to pay $850,343.84 to settle allegations that the acute care facility submitted or caused to be submitted false claims for payment to the Medicare program in violation of the Federal False Claims Act, the Anti-Kickback Statue, and the Physician Self-Referral Law announced the Office of Inspector General of the Department of Health and Human Services and David J. Hale, United States Attorney for the Western District of Kentucky.

“Pursuing health care fraud is a priority of my Office and the Department of Justice. We will continue to work with the Department of Health and Human Services to ensure that medical providers who overbill Medicare are investigated,” stated David J. Hale, United States Attorney for the Western District of Kentucky. “Those that do not follow the rules designed to safeguard our nation’s limited health care resources will be held to account.”

According to the settlement agreement, the United States contends Dr. Raymond Charette, an orthopedic surgeon in private practice, received improper financial benefits from JPMC and, in return, referred patients to and treated patients at JPMC, a 107 licensed bed facility located in Mayfield, Kentucky.

The improper financial relationship, alleged by the United States, between JPMC and Dr. Charette, occurred for a period of seven years beginning in July 2004 through August 31, 2011. The United States alleged that from November 1, 2007, through August 31, 2011, JPMC employed a nurse practitioner who worked primarily and extensively for Dr. Charette; from July 1, 2007, through December 31, 2007, JPMC relieved Dr. Charette from his monetary rental obligations for space in JPMC’s medical building without modifying the lease in a signed agreement; and from July 6, 2004, through August 31, 2011, JPMC failed to collect rent on an equipment lease for an x-ray machine used by Dr. Charette’s medical practice. Having received financial benefits in the form of a Nurse Practitioner and reduced rental obligations, Dr. Charette referred patients to and treated patients at JPMC. As a result of these actions, the United States contends that JPMC submitted claims to Medicare for services rendered to these referred patients in violation, of the False Claims Act, the Anti-Kickback Statue, the Physician Self-Referral Law, and other federal statutes and common law doctrines.

This settlement agreement is neither an admission of liability by JPMC nor a concession by the United States that its claims are not well founded.

This case was prosecuted by Assistant United States Attorney Benjamin S. Schecter and it was investigated by the Office of Inspector General for the Department of Health and Human Services.