Hospitals and Contracted Physicians Beware: Washington Hospital System Settles False Claims Liability Based on Common RVU and wRVU Compensation Methodologies

A Washington hospital system recently paid $22.7 million to settle false claims liability based on fairly common RVU and wRVU compensation methodologies, which pays surgeons based on a productivity metric that increases with the complexity of the surgery performed.

As part of the settlement agreement, the hospital admitted that it had employed Drs. A and B and that hospital medical personnel had articulated concerns that Drs. A and B: (1) were endangering the safety of patients; (2) created through their surgeries an excessive level of complications and negative outcomes; (3) performed surgery on candidates who were not appropriate for surgery; and (4) failed to properly document their procedures and outcomes.

The hospital must also enter a Corporate Integrity Agreement with HHS-OIG which requires, among other things, that the hospital implement and maintain a number of quality-of-care and patient safety obligations and retain outside experts to perform annual claims and clinical quality systems reviews. Read more from the American Health Law Association here.

This article was submitted by Robert Yates, Office of the Indiana Attorney General. If you would like to submit content or write an article for the Health Care & Life Sciences Section, please email Kara Sikorski at ksikorski@indybar.org.

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