Halifax Hospital Medical Center (“Halifax”), in Daytona Beach, Florida, is preparing to battle the United States in what could be the largest whistleblower case of its kind in the nation.
According to whistleblower Elin Baklid-Kunz, Halifax violated the False Claims Act by submitting claims to Medicare and Medicaid for unnecessary hospital admissions and inappropriate spinal surgeries, and paid illegal kickbacks to physicians. Baklid-Kunz, the current director of physician services for Halifax, claims the wrongdoing went on between 2000 and 2011.
Baklid-Kunz filed a whistleblower action under the qui tam provisions of the False Claims Act in 2009.
The complaint alleges that between 2000 and 2011, Halifax billed Medicare and other government health care programs more than $30 million for unnecessary admissions and paid over $178 million in illegal kickbacks to physicians. According to the whistleblower, one of several internal audits conducted by the hospital showed that during one month in 2008, 82 percent of patients admitted for chest pain did not meet the criteria for admission.
The United States partially intervened with respect to allegations that Halifax violated the Stark law, which prohibits medical facilities from billing Medicare for services referred by physicians that have an improper financial relationship with the facility. In this case, the government alleges that Halifax paid improper incentive bonuses to six oncologists and three neurosurgeons.
The trial is set to begin in the U.S. District Court for the Middle District of Florida in November. Under the qui tam provisions of the False Claims Act, the whistleblower may be entitled to a portion of the recovery as her reward.