A south Texas hospital agreed to pay $27.5 million to settle a qui tam suit. San Antonio Express-News (10/31, Brezovsky). The whistleblower got $5.5 million for his trouble and the taxpayers got the rest!
Patients are a source of profit for hospitals. Consequently, hospitals have an incentive to encourage doctors to send their patients to them. It is illegal for a hospital to pay a doctor – directly or indirectly – for sending patients to their hospital. Whistleblowers who report hospitals for “paying for referrals” stand to help themselves while saving substantial taxpayer dollars. The illegal payments are frequently hidden as compensation for other services or passed on as reduced rent or other perks. This is an opportunity for reducing the cost of health care without penalizing the victim of medical malpractice.
Reigning in this type of situation will help reduce health care costs without sacrificing the quality of health care or the rights of patients.
