CoxHealth to pay $60M to settle with feds

Springfield, MO-based health system CoxHealth has agreed to pay $60 million to resolve a myriad of charges related to its financial relationships with referring physicians and its Medicare billing practices. According to an announcement by the U.S. Department of Justice, which conducted an investigation, CoxHealth violated the False Claims Act, anti-kickback statute and Stark rules on self-referral between 1996 and 2005.

CoxHealth executives, who do not admit to wrongdoing, have attributed the DoJ's allegations to a disagreement over how to interpret federal regulations regarding billing and medical-director agreements for its Ozarks Dialysis Services. It also concedes that the DoJ didn't like the revenue source used to compensate the medical group staffing its Ferrell-Duncan Clinic. The issues were all identified initially by Cox itself and reported to the government, according to CEO Robert Bezanson.

Under the terms of the settlement, Cox will pay $35 million initially, then make five payments of $5 million per year. It will also enter into a five-year corporate integrity agreement with the HHS Office of the Inspector General.

To learn more about the settlement:
- read this Modern Healthcare piece (reg. req.)

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