Attorney General Sam Olens announced today that Georgia has reached a civil settlement agreement with Health Management Associates, Inc. (HMA) and Clearview Regional Medical Center. The hospital, which is located in Monroe, Ga., was previously named Walton Regional Medical Center and was owned by hospital operator HMA during the time period relevant to the lawsuit. It is now owned by Community Health Systems.
The defendants agreed to pay Georgia and the United States $991,925 to resolve allegations that they submitted false claims to the Georgia Medicaid program from 2008 to 2009 by providing kickbacks to Clinica de la Mama, an obstetric clinic serving primarily undocumented Hispanic women, and related entities to induce the referral of those patients to its hospital for labor and delivery. Certain of these patients were eligible for Medicaid while others qualified for Emergency Medical Assistance, a Medicaid program providing coverage for emergency conditions, including childbirth for undocumented aliens. Georgia will receive $396,770 as its share of the settlement.
“I am pleased to announce that my office, in conjunction with the federal government, has reached a settlement with HMA and Clearview Regional Medical Center to resolve allegations that they paid kickbacks in exchange for patient referrals of vulnerable women,” said Olens. “Paying kickbacks for patients violates the law and defrauds Georgia Medicaid. The allegations that the defendants in this case took advantage of undocumented pregnant women about to give birth are extremely troubling. Health care providers’ top priority should be the care of their patients, not their bottom line.”
The case began with a lawsuit filed by Ralph D. Williams in the Middle District of Georgia under the whistleblower provisions of the federal False Claims Act and the Georgia False Medicaid Claims Act, which allow private citizens to bring civil actions on behalf of the government and share in any recovery obtained. The case is captioned United States ex rel. Williams v. Health Management Assocs., et al., No. 3:09-CV-130 (M.D. Ga.). The state of Georgia intervened in the civil action and filed its Complaint in Intervention on July 31, 2013. The United States also intervened in the civil action. Mr. Williams will receive $83,321.70 from Georgia as his share of the state’s recovery.
The claims settled in the civil settlement agreement are allegations only, and there has been no determination of liability. As part of the same case, Georgia also intervened against other Georgia hospitals owned by Tenet Healthcare Corporation. That litigation is ongoing.
These matters were investigated by the Office of the Attorney General for the State of Georgia in coordination with the United States Attorney’s Office for the Middle District of Georgia, the Commercial Litigation Branch of the United States Department of Justice’s Civil Division, the Department of Health and Human Services Office of Inspector General, and the Federal Bureau of Investigation.