Video: Every Case Tells a Story| Webinar: ACR/CHEST ILD Guidelines in Practice

An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

  • Conditions
    • Axial Spondyloarthritis
    • Gout and Crystalline Arthritis
    • Myositis
    • Osteoarthritis and Bone Disorders
    • Pain Syndromes
    • Pediatric Conditions
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Sjögren’s Disease
    • Systemic Lupus Erythematosus
    • Systemic Sclerosis
    • Vasculitis
    • Other Rheumatic Conditions
  • FocusRheum
    • ANCA-Associated Vasculitis
    • Axial Spondyloarthritis
    • Gout
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Systemic Lupus Erythematosus
  • Guidance
    • Clinical Criteria/Guidelines
    • Ethics
    • Legal Updates
    • Legislation & Advocacy
    • Meeting Reports
      • ACR Convergence
      • Other ACR meetings
      • EULAR/Other
    • Research Rheum
  • Drug Updates
    • Analgesics
    • Biologics/DMARDs
  • Practice Support
    • Billing/Coding
    • EMRs
    • Facility
    • Insurance
    • QA/QI
    • Technology
    • Workforce
  • Opinion
    • Patient Perspective
    • Profiles
    • Rheuminations
      • Video
    • Speak Out Rheum
  • Career
    • ACR ExamRheum
    • Awards
    • Career Development
  • ACR
    • ACR Home
    • ACR Convergence
    • ACR Guidelines
    • Journals
      • ACR Open Rheumatology
      • Arthritis & Rheumatology
      • Arthritis Care & Research
    • From the College
    • Events/CME
    • President’s Perspective
  • Search

Adventist Health System to Pay $118 Million to Settle Fraud Claims

Brendan Pierson  |  September 23, 2015

(Reuters)—Florida-based healthcare system Adventist Health System has agreed to pay $118.7 million to settle a whistleblower lawsuit that accused it of paying kickbacks to doctors in exchange for referrals, attorneys for the plaintiffs announced on Monday.

The agreement comes in a lawsuit filed by three former employees of Adventist’s Park Ridge Health hospital in Hendersonville, N.C., in 2012. It also resolves claims in a separate 2013 lawsuit containing similar accusations.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

The bulk of the settlement, $115 million, will go to the federal government, with $3.4 million going to the state of Florida and the rest divided among North Carolina, Tennessee and Texas, according Peter Chatfield, a lawyer for the plaintiffs.

Chatfield said it was the largest settlement ever paid in a case involving hospitals paying doctors for referrals. In addition to the kickback accusations, the settlement also resolved claims that Adventist overbilled government healthcare programs.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

Adventist’s legal department did not return a call seeking comment.

The whistleblowers could ultimately receive 15 to 25% of the settlement, but their share has not yet been decided, according to their attorneys.

The 2012 lawsuit, filed in North Carolina federal court, alleged that the kickbacks took the form of inflated salaries, bonuses and a widespread practice of allowing physicians to overbill in exchange for referring their patients to Adventist facilities.

“Unlawful financial arrangements between heath care providers and their referral sources raise concerns about physician independence and objectivity,” Benjamin Mizer, head of the U.S. Justice Department’s Civil Division, said in a statement. “Patients are entitled to be sure that the care they receive is based on their actual medical needs rather than the financial interests of their physician.”

The U.S. government and the four states intervened in the case after it was filed.

Share: 

Filed under:Legal Updates Tagged with:fraudHealth careHealth Insurancelawsuit

Related Articles

    U.S. State, Local Government Lawsuits Over Opioids Face Uphill Battle

    June 5, 2017

    BOSTON (Reuters)—A growing number of U.S. states, counties and cities are filing lawsuits accusing drug companies of deceptively marketing opioid painkillers to downplay their addictiveness, but some lawyers say the industry’s highly regulated nature could pose a hurdle to their success. Ohio on Wednesday became the latest, and largest, state or local government to bring…

    Monkey Business Images/shutterstock.com

    Assessing Autoimmune Disease Symptoms in Silicone Breast Implant Recipients

    December 15, 2016

    My nurse, Joanne, took me aside before I began my next consult. “Room No. 5, breast implant patient. Her lawyer organized the records.” She handed me a hefty three-ring notebook organized by color-coded tabs. “Her attorney called just now,” Joanne raised an eyebrow, “and told me to tell you that, to save time, he highlighted…

    Tail Insurance Protects Against Medical Malpractice Claims from Previous Jobs

    February 1, 2013

    Physicians who are resigning, retiring, switching jobs, or are terminated should consider tail insurance to cover malpractice claims brought after they’ve left their current employer

    Tenet Healthcare to Pay More Than $513 Million in Fraud Scheme

    October 4, 2016

    WASHINGTON (Reuters)—U.S. hospital chain Tenet Healthcare Corp. and two of its Atlanta-area units will pay more than $513 million to resolve criminal charges and civil claims relating to a scheme to defraud the U.S. and pay kickbacks in exchange for patient referrals, the U.S. Department of Justice said on Monday.1 Tenet had disclosed in August…

  • About Us
  • Meet the Editors
  • Issue Archives
  • Contribute
  • Advertise
  • Contact Us
  • Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 1931-3268 (print). ISSN 1931-3209 (online).
  • DEI Statement
  • Privacy Policy
  • Terms of Use
  • Cookie Preferences