Irving-based Christus Health and its Santa Fe, N.M., hospital will pay $12.2 million to the federal government, settling a whistleblower lawsuit. Washington, D.C.-based Phillips & Cohen alleged that Christus and its Santa Fe hospital, St. Vincent Regional Medical Center, “manipulated federal funding for an indigent care program to boost their revenues.”
According to Phillips & Cohen, the alleged scheme involved New Mexico’s sole community provider fund, sole community provider supplemental payments programs, and “donations” St. Vincent made to Santa Fe County. It’s believed the donations were cover-ups for the state’s share of funding “needed to obtain federal matching funds from 2001 to 2009,” according to the lawsuit.
The sole community provider programs use state and federal funds to pay hospitals’ costs for treating indigent persons, or those too poor to have medical insurance. In New Mexico, these programs must provide an estimated $1 for every $3 the federal government pays to cover these expenses. Hospitals can draw lump sums from the program on a quarterly basis.
The complaint states that Christus and its St. Vincent hospital “transformed donations to Santa Fe County into discretionary supplemental Medicaid payments” that refunded St. Vincent in full for its donations, and paid St. Vincent “additional amounts of unwarranted federal funding that total approximately three times the amount of the hospital’s investment in such refunded ‘donations.’”
Read more at D CEO Healthcare.