July 23, 2008 - CoxHealth System of Springfield, Missouri said it will pay $60 million to the federal government to end a five-year civil investigation into alleged improper Medicare billing practices and prohibited financial arrangements with Ferrell-Duncan Clinic Inc. Article from The News-Leader.
"The deal resolves two issues CoxHealth discovered and self-reported in 2005: billing Medicare for dialysis services that it was ineligible to bill the government for, and using an incorrect revenue source to pay contracted Ferrell-Duncan Clinic physicians." Article from the Springfield Business Journal.
The settlement does not include resolution of a wrongful termination suit filed by two former dialysis employees, an administrator and nurse manager. Article from The News-Leader.
Information from CoxHealth, including a news release, FAQ, and settlement information.
News release from the U.S. attorney.
Additional AP article via The Missourian.
May 1, 2008 - CoxHealth System of Springfield, Missouri expects to pay $60 million to settle a federal investigation that involves and alleged overcharges to government programs for kidney dialysis services and for payments to physicians for services they allegedly never performed. Article from News-Leader.
CoxHealth of Springfield, Missouri is a three-hospital organization with more than 50 physician clinics and over 8,000 employees. In June 2005, two former Cox employees, a dialysis administrative director and clinic director, filed a lawsuit alleging they were fired after they talked to federal investigators about possible Medicare Method II billing fraud and suspect reimbursement practices for nephrologists.
September 17, 2007 - CoxHealth officials have confirmed the system has set aside $26 million in a special fund for possible expenses and settlement of an ongoing, wide-ranging federal probe. Story from The News-Leader (Springfield, MO).
"U.S. attorneys have said in court documents they are investigating whether Cox officials committed Medicare fraud by knowingly overcharging the government program for kidney dialysis services by using a method of billing it was not eligible to use.
Investigators are also looking at whether Cox officials paid two kidney specialists to serve as medical directors at Ozarks Dialysis Services even though they did not provide a service, according to a court document."
November 21, 2006 - The U.S. attorney has submitted a confidential status report to a federal judge about its ongoing criminal investigation for dialysis-related Medicare fraud at CoxHealth in Springfield, Missouri. Article from News-Leader.
October 3, 2006 - A U.S. District Court judge has lifted the stay, or delay, he imposed in November 2005 on the lawsuit against CoxHealth (Springfield, MO) filed by two former dialysis administrators. Story from The News-Leader.com.
Roger Cochran and Dennis Morris claim they were wrongfully fired in 2004 after it became known they cooperated with federal law enforcement officials investigating alleged fraudulent business practices at Cox, court records show.
CoxHealth has been ordered by a U.S. District Court judge to produce internal files that led to the firing of two dialysis supervisors. Article from The News-Leader.com.
July 10, 2006 - The government's criminal investigation of CoxHealth will continue with a new grand jury, but federal investigators asked a judge to further delay a related civil case.
Two fired CoxHealth employees filed the civil suit in June 2005, alleging that after numerous internal complaints to Cox went disregarded, they gave government officials documentation about illegal activity at Ozarks Dialysis Services, a part of Cox. A month later Cox fired them, they said. Article from News-Leader.com.
July 3, 2006 - A federal grand jury issued no indictments in the CoxHealth Medicare fraud investigation before ending its term.
Among the unanswered questions after the grand jury's dismissal Thursday is the status of an overlapping civil suit filed on behalf of two fired Cox employees. Their attorney, Matthew Placzek, declined to comment about the issue Thursday. Article from News-Leader.com.
June 26, 2006 - The federal grand jury hearing evidence about alleged Medicare fraud at CoxHealth is scheduled to meet for a final time this week in Kansas City. Article from The News-Leader.com.
May 19, 2006 - Federal attorneys have the go-ahead to complete their criminal investigation of CoxHealth without future interference from an overlapping civil lawsuit.
Government lawyers have been hearing evidence of alleged Medicare fraud at CoxHealth (Springfield, MO) for several months. Article from The News-Leader.
A Kansas City grand jury hearing evidence of alleged Medicare fraud at CoxHealth in Springfield could issue indictments or take other action in the case by July 1, investigators told a federal court judge Wednesday. Story from The News-Leader.
The News-Leader has a special section on the legal proceedings against CoxHealth.
January 21, 2006 - The government's ongoing criminal investigation of CoxHealth system in Springfield (Missouri) has progressed to a Kansas City grand jury, a court document filed by U.S. Attorney Todd Graves revealed this week. Story from News-Leader.
November 23, 2005 - A whistleblower lawsuit filed against CoxHealth (Springfield, MO) in June by two fired dialysis employees will remain on hold for six months so federal authorities can complete a related criminal investigation at Cox, a judge ruled Monday. Story from News-Leader.
September 20, 2005 - CoxHealth's legal woes, which once consisted of a federal audit and a civil suit filed by two former employees, may now include a full-blown criminal proceeding. Article from the Springfield Business Journal.
September 19, 2005 - The News-Leader of Springfield, Missouri has published two background news articles on the government investigation into potential Medicare billing fraud for dialysis services at CoxHealth.
"CoxHealth not alone in scrutiny from feds" - Sept. 18 article
"Case offers insight behind Cox investigation"- Sept. 18 article
September 16, 2005 - CoxHealth CEO Robert Bezanson used a four-page memo to employees, physicians and volunteers on Thursday to rebut government criticism that Cox misstated its level of cooperation with a federal investigation. Article from News-leader.com.
Sept. 15 memo from CoxHealth.
September 14, 2005 - CoxHealth officials will not formally respond to government criticisms that the health system misstated its cooperation with an ongoing federal criminal investigation, a hospital representative said. Story from the News-Leader.com.
Motion filed (1-page pdf file) by Plantiffs Cochran and Morris on Sept. 12.
Government's reply (7-page pdf file) to Defendent Cox's response to the Governments's motions to intervene and stay discovery (filed Sept. 9).
September 12, 2005 - CoxHealth has misstated its cooperation with the federal government during its ongoing criminal investigation of Cox business practices, a U.S. attorney said in court papers filed Friday. Story from the News-Leader.com.
September 10, 2005 - Two fired CoxHealth employees should not be forced to wait years for their civil "whistle-blower" lawsuit to resume against the health system, their lawyers said Friday. Story from the News-leader.com.
September 5, 2005 - The News-Leader newspaper of Springfield, Missouri has published two opinion pieces on possible Medicare fraud at the CoxHealth organization.
"Cox owes public more than spin" - editorial from The News-Leader (link is no longer available)
"A nonprofit hospital is more than just another business. It has an obligation to its community to deliver quality health care. Because it is a public trust, it also is called to a greater level of integrity and transparency than other businesses."
"CoxHealth shouldn't turn blind eye to improprieties" - letter to editor from John L. Putnam, MD (link is no longer available)
August 27, 2005 - The Associated Press has released a story on the federal investigation into possible Medicare fraud at CoxHealth regarding billing practices for dialysis and physician reimbursement.
August 26, 2005 - In its first official acknowledgment, a U.S. attorney revealed in a court document this week that five former and current CoxHealth administrators are the focus of an ongoing federal investigation looking into Medicare fraud. Article from the News-Leader of Springfield, Missouri.
U.S. Attorney Todd Graves also made a motion that the court halt a related civil suit filed by a former dialysis administrative director and a former dialysis clinical director, as upcoming interviews and depositions of CoxHealth officials could harm the government's investigation. Article from the News-Leader.
An August 25th memo on the federal investigtion (31-page pdf file) written by the CoxHealth CEO to employees was also posted on the News-Leader web site.
June 9, 2005 - CoxHealth of Springfield, Missouri is a three-hospital organization with more than 50 physician clinics and over 8,000 employees. On Wednesday, June 8, two former Cox employees, a dialysis administrative director and clinic director, filed a lawsuit alleging they were fired after they talked to federal investigators about possible Medicare Method II billing fraud and suspect reimbursement practices for nephrologists.
The lawsuit is available on-line as a 15-page pdf file.
The former clinical director of Ozarks Dialysis, Roger Cochran, RN, had been employed at Cox Hospital/CoxHealth for the last 22 years. He was fired on May 16th.
The former administrative director, Dennis Morris, has been employed at CoxHealth in that capacity since 1995. He was fired on May 18th.
The two former Ozarks Dialysis Services employees claim in their federal suit that CoxHealth violated the federal Whistleblowers Protection Act, public policy, and state law when it fired them after they talked to federal investigators about possible criminal conduct at Cox.
Their lawsuit states they were targeted for termination because they had inside knowledge of:
Federal investigators have been mum with the public about an investigation they are conducting of CoxHealth and Ferrell-Duncan Clinic. Article from News-Leader.com. (link is no longer available)
In December 2004, the suit states, CoxHealth began to question the legality of its Method II billing practice in light of a decision from the U.S. District Court for the Eastern District of Missouri in United States v. Gambro Healthcare. Story from AP via Boston.com.
On December 2, 2004, Gambro Healthcare US announced it had reached a final agreement with the U.S. Department of Justice to resolve the investigation stemming from June 2001. Gambro set aside $355 million to cover payment of the settlement amount. Press release from the Gambro.(link is no longer available)
As part of the settlement, Gambro Healthcare US has entered into a 5-year Corporate Integrity Agreement (63-page pdf file).This message has been edited. Last edited by: Gary Peterson,
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