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Fri Oct 4, 2019, 12:59 AM

Lancaster Surgeon to Pay $4.25 Million to Resolve False Billing and Kickback Claims

PHILADELPHIA – First Assistant United States Attorney Jennifer Arbittier Williams announced a $4.25 million civil settlement with Glenn A. Kline, D.O. and Community Surgical Associates to resolve civil allegations relating to kickbacks received from two hospitals formerly operated by Health Management Associates (HMA) in Lancaster, Pennsylvania, in violation of the False Claims Act and Anti-Kickback Statute. Dr. Kline’s case is related to a larger investigation under which HMA agreed to pay $260 million to the United States to settle claims arising from HMA’s fraudulent billing practices in multiple healthcare institutions across the United States.

Between 2009 and 2012, as alleged in the relators’ complaint, Dr. Kline practiced as a general surgeon in Lancaster, Pennsylvania. Dr. Kline was a major source of surgical business in the Lancaster area. His ability to refer patients to two former HMA hospitals, Lancaster Regional Medical Center and Heart of Lancaster Medical Center, gave Dr. Kline significant leverage over HMA as it attempted to compete in the Lancaster market.

To secure Dr. Kline’s referrals, the complaint alleges that HMA compensated Dr. Kline by paying him exorbitantly more than the fair market value of his services. Dr. Kline was being paid 300% more than the Medical Group Management Association (MGMA) median salary for comparable general surgeons, and no fair market value analysis was done to support this payment. In addition to his excessive salary, Dr. Kline demanded, and was paid, additional amounts to benefit his practice, Community Surgical Associates. As alleged, Dr. Kline was paid these amounts as kickbacks for his referral of patients to Lancaster Regional Medical Center and Heart of Lancaster Medical Center, which in turn billed federal health care programs for those patients’ services. According to the complaint, these arrangements were intentionally structured to disguise payments which were, in actuality, payments for patient referrals, not for legitimate services.

“Our resolution of this matter and the significant recovery we have obtained from this physician show once again that no matter how complex the fraud scheme is, we will find it, stop it, and punish it,” said First Assistant U.S. Attorney Williams. “The alleged improper physician inducements that Dr. Kline demanded, and received, are a form of ‘pay to play’ business practice that could compromise professional judgment. In sum, this conduct must be rooted out because it interferes with a physician’s ability to provide top-notch patient care to American citizens.”

Read more: https://www.justice.gov/usao-edpa/pr/lancaster-surgeon-pay-425-million-resolve-false-billing-and-kickback-claims

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