AUSTIN (KXAN) — Three area Ascension Texas hospitals are paying $20.9 million in fines for paying two physician groups above fair market value for services.
Dell Seton Medical Center at the University of Texas, Ascension Seton Medical Center Austin and Ascension Seton Williamson self-reported the conduct to the Office of the Inspector General for the U.S. Department of Health and Human Services, a release from the office said. The fines are because the hospitals allegedly violated the Civil Monetary Penalties Law “including provisions applicable to physician self-referrals and kickbacks,” the release said.
The OIG listed seven instances where the three hospitals were alleged to be found in violation but did not name the physician groups involved:
- Dell Seton at UT and Ascension Seton Williamson paid an orthopedic surgery group above fair market value for on-call coverage
- Dell Seton at UT paid an Austin physician practice above fair market value for on-call coverage
- Ascension Seton Austin paid an Austin practice above fair market value for transplant on-call coverage and administrative services
- Ascension Seton Williamson paid an Austin practice above fair market value to lease the practice’s employed RNs and surgical technologists that assisted in surgeries by the practice’s doctors at the hopsital
- Ascension Seton Austin paid an Austin practice above fair market value for administrative services relating to its thoracic surgery program
- Dell Seton at UT paid an Austin practice in the form of free physician assistants employed at Ascension Seton Austin, and the practice should have paid them
- Ascension Seton Austin gave an Austin practice free office space and provided related staff, service and supply support for a half-day per week to perform clinical services
HHS sent a statement about the alleged violations and said they couldn’t say very much publicly about them, and that KXAN needs to file a Freedom of Information Act request for the settlement agreement. KXAN filed the request Friday.
They were, however, able to clarify that through the self-reporting by the hospitals, the two physician groups were paid “amounts inconsistent with fair market value,” and HHS said that “implicates and potentially violates the anti-kickback statute.”
“One purpose of the anti-kickback statute is to protect patients from inappropriate medical referrals or recommendations by health care professionals who may be unduly influenced by financial incentives,” the statement said. “When payments by a hospital to a physician are inconsistent with fair market value, there is an indicia that one purpose of the payments is to induce the physician’s Federal health care program referrals to the hospital.”
HHS considers the issue resolved.
We’ve also asked the National Health Care Anti-Fraud Association for an interview to provide more context. We will update this story when we get the interview.