Baptist Health System, Inc. (“Baptist Health”) will pay $2.5 million to settle allegations by a whistleblower in a qui tam lawsuit that it submitted false claims to Medicare, Medicaid, and TRICARE. According to its website, Baptist Health was founded in 1955, and is the only locally governed health system in the Jacksonville, Florida area. Baptist Health is the parent company of a network of affiliated hospitals, to wit: Baptist Medical Center Jacksonville, Baptist Medical Center Beaches, Baptist Medical Center Nassau, Baptist Medical Center South and Wolfson Children’s Hospital.
In January 2012, a former patient referral coordinator for the neurology practice at Baptist Medical Center Jacksonville, Verchetta Wells, filed a whistleblower lawsuit against Baptist Health and Dr. Sean Orr under the qui tam provisions of the False Claims Act in the U.S. District Court for the Middle District of Florida. The whistleblower alleged that Dr. Orr, the former Chief of Neurology at Baptist Medical Center Jacksonville, intentionally misdiagnosed healthy patients with serious neurological conditions like brain lesions and multiple sclerosis in order to bill government health care programs for expensive treatments and medications. The whistleblower claimed that the submission of bills to government health care programs for treatments that were not medically necessary violated the False Claims Act.
The whistleblower claimed that when Baptist Health discovered Dr. Orr’s alleged fraud against government health care programs, it worked to conceal his conduct rather than report it to the federal and Florida authorities. According to the Justice Department, Baptist Health uncovered Dr. Orr’s misconduct in or around October 2011, but did not disclose it to the government until September 2012.
According to the qui tam complaint, hundreds of patients received unnecessary treatments and medications as a result of the misdiagnoses. The whistleblower claimed that Baptist Health did not initially report Dr. Orr’s conduct in hopes of avoiding liability.
Baptist Health will pay $2.5 million to settle the False Claims Act allegations. Of the settlement amount, the Florida Medicaid program will receive approximately $19,000 and the whistleblower will receive $424,155 as her reward under the qui tam provisions of the False Claims Act.
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