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“Complaint Details Fraud Allegations Against Kalispell Regional Healthcare”

Phillips & Cohen attorney Peter Chatfield is cited at length in an article in the Flathead Beacon about an alleged kickback scheme coordinated by Montana-based Kallispell Regional Healthcare. Chatfield provided the Beacon an overview of whistleblower lawsuits and contextualized the type of fraud allegedly taking place at Kallispell Regional Healthcare’s hospitals:

Peter Chatfield, a whistle-blower attorney with the Washington D.C.-based firm Phillips and Cohen, which handled the largest health-care fraud settlement ever made involving physician referrals to hospitals, said Kalispell Regional Healthcare must now respond to the complaint, likely by filing a motion to dismiss.

Both of the statutes cited in the complaint are designed to provide a safe harbor for “whistleblowers,” allowing them to work with the government to stop kickbacks and subsequently receive a reward by filing a “qui tam” lawsuit under the False Claims Act.

Chatfield said the whistleblower statutes are important because they protect whistleblowers like Mohatt from retaliation while holding powerful institutions accountable.

“It’s like a sledge hammer. It’s a very powerful litigation tool,” he said. “But in the case of both statutes, the goal is to make sure that when physicians are referring patients for care or testing or labs, that they are referring them for medically necessary reasons, not to line their own pockets because the referrals are incentivized.”

The impact of such a money-for-referrals scheme is harmful to patient care because it drives up health-care costs and eliminates competition while raising the median income of physicians, Chatfield said. It can also undermine the level of care a patient receives by referring them to medically unnecessary services.

The cases can also be prohibitively difficult for government agencies to investigate, both in the amount of time and resources they require, Chatfield said

In many cases, Chatfield said a particular specialty medical service is overutilized.

“What the government is really looking for when they investigate these cases are arrangements in which a lot more medical care is given than is necessary,” Chatfield said.

Read the full story on the Flathead Beacon’s website.

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