Tyrone Hospital is being sued by two former employees who contend the medical facility submitted false and fraudulent billings to the United States government along with paying kickbacks to doctors for patient referrals.
The hospital’s former CEO Thomas Bartlett and former Human Resources Director Kimberly Gummo brought the suit on behalf of the United States as well as a separate claim for what they contend was retaliation that led to their termination as employees.
A clerk at the United States District Court in Johnstown confirmed that court documents state that Bartlett recommended “self-disclosure” to the hospital’s board of directors following an internal investigation of the kickback and self-referral issues. The documents contend that instead of acting on his recommendation, Bartlett was fired.
The suit contends the practices date back to at least 1994.
Bartlett and Gummo filed their initial court action in March of 2004 and have filed subsequent amended complaints. In addition to Tyrone Hospital, other companies, several doctors and others are named in the suit. A motion to dismiss the case on behalf of several of the defendants was made last year. An attorney for Bartlett and Gummo said additional motions to have the case dismissed by several defendants have been filed since an amended complaint was filed in February.
Attorney Andrew M. Stone of Pittsburgh said Bartlett and Gummo are bringing the case on behalf of the federal government. He said the case is being brought under the federal False Claims act.
Stone said the suit alleges there were relationships that were put in place between the hospital, physicians and business ventures that were under taken by physicians and others at the hospital including former CFO Daniel Ashcroft.
According to Stone, Ashcroft was associated with an outside business called Tri County Imaging Associates, Inc. while he worked at the hospital.
Attorney Stone also said Bernard DiGiacobbe was the head of the hospital’s radiology department at the same time he was involved with Tri County Imaging, Inc.
Stone said that as a result of the internal investigation Tri County Imaging, Inc. came to an end.
Stone explained that if bills to the federal government were generated as a result of illegal relationships then such billing would constitute a false claim. Most of the billing was under the government’s Medicare and Medicaid programs. Stone said the alleged false billings for payments were also made to other government healthcare programs. Stone said the suit also contends violations of anti-kickback laws and the Stark Statute regarding self-referrals.
One of the other companies named in the suit is Quorum Health Resources LLC, a company that the hospital uses for management services.
Earlier this month, the hospital announced it had decided to discontinue its relationship with QHR. At the time, Judith Norris, president of the hospital’s board of directors, said the move to discontinue the hospital’s relationship with QHR is a direction the board of directors thinks will better serve the community now and in the future. A hospital press release said resources that would have been directed to management contract fees could now be redirected to hospital operations. The QHR contract ends this Saturday.
At the time of the announcement regarding the severing of its relationship with QHR, the hospital also announced it was closing its obstetrics unit.
Tyrone Hospital has also been dealing with court proceedings involving a suit brought on behalf of a boy who suffered medical problems after his birth at the hospital in the mid 1990s.
Earlier this year, a jury awarded more than $4 million in the case. The hospital and a doctor involved in the case have been seeking to have the reward reduced or have the case retried with an limited award amount. Judge Hiram Carpenter issued a gag order in the case earlier this month to prevent the parties involved from talking about it.
The judge is scheduled to hear oral arguments on motions that have been filed in the case on July 17.