Health Care Providers To Pay $1 Million For False Claims, Improper Referrals

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WHEELING, WEST VIRGINIA -- Two Ohio Valley health care providers will pay a million dollar penalty after violating Federal law by submitting false claims to Medicare.

United States Attorney William J. Ihlenfeld, II, announced that Devender Batra, M.D., and Belmont Cardiology, Inc. will pay $1 million to the United States after causing East Ohio Regional Hospital and Ohio Valley Medical Center to submit fraudulent claims to Medicare from January 2009 to August of 2010, in violation of the Federal False Claims Act. The settlement ends an investigation into improper compensation arrangements between Dr. Batra, East Ohio Regional Hospital and Ohio Valley Medical Center. The arrangements with Dr. Batra and Belmont Cardiology led the hospitals to submit false claims for prohibited referrals for various health services in violation of Federal law.

AThese types of prohibited referrals are a significant problem and lead to increased health care costs for everyone,” said U.S. Attorney Ihlenfeld. “Medicare expects that a physician’s referral of a patient to a hospital will be free from improper influences, and when it’s not we will act to hold the wrongdoers accountable.”

The investigation arose after the U.S. Attorney’s Office resolved claims against East Ohio Regional Hospital and Ohio Valley Medical Center for entering into improper compensation arrangements with Dr. Batra and others.

AReferrals of patients that are motivated, to any degree, by prohibited compensation arrangements may lead to costly and unnecessary medical care. For this reason we encourage anyone who has knowledge of such arrangements between a medical facility and a physician to report it,@ said Ihlenfeld.

“Sound medical decision making cannot be influenced by financial gain”, said Nick DiGiulio, Special Agent in Charge for the Inspector General’s Office of the U.S. Department of Health and Human Services in Philadelphia. “We are pleased that these allegations are resolved and will continue to work with the Department of Justice to root out illegal, wasteful business arrangements.”

The False Claims Act is a federal law that allows the government to sue health care providers who submit false or fraudulent claims to federal health care programs, such as Medicare, or cause others to do so. False claims submitted by medical providers cost federal health care programs billions of dollars each year.

Dr. Batra is a physician who practices cardiology in Belmont County, Ohio and the surrounding area. Dr. Batra is the President of Belmont Cardiology Inc., a medical corporation.

This matter was handled by Assistant United States Attorney Alan G. McGonigal, in coordination with the United States Department of Health and Human Services, Office of Inspector General.