SOUTH BEND —Two local lawyers claim 62 Indiana hospitals, including two in St. Joseph County, systematically falsified records and defrauded taxpayers of more than $300 million.
A federal civil lawsuit, unsealed Wednesday, alleges the hospitals made false claims to receive federal grant dollars and participated in kickback schemes by over-billing for the release of electronic medical records.
Memorial Hospital of South Bend, Saint Joseph Regional Medical Center in Mishawaka, St. Joseph Regional Medical Center in Plymouth, 59 other hospitals and a Georgia corporation are accused of receiving more than $300 million in taxpayer dollars “in a fraudulent manner that constitute false claims for public funding.”
Michael Misch and Bradley Colborn, attorneys for South Bend law firm Anderson, Agostino & Keller, brought the suit in September 2016 on behalf of the United States and state of Indiana after experiencing difficulties in obtaining electronic medical records from local hospitals in their work on personal injury and medical malpractice cases.
According to Misch and Colborn, the hospitals violated provisions of the American Recovery and Reinvestment Act of 2009, which created grant programs to encourage hospitals to implement new electronic health record systems. To receive the grants, hospitals had to release information that showed the number of medical records requests annually and if the records were turned over to those requesting them within three business days. Hospitals that failed to achieve at least 50 percent of their requests within the time frame would not be eligible to receive funding.
Misch and Colborn began tracking the instances where they received electronic records from four hospitals, including Memorial Hospital and both Saint Joseph Regional Medical Center locations, beginning in 2013. The lawyers logged the number of times they received records after the required three business day period, and compared those numbers to the hospitals’ public disclosures.
The lawsuit says the pair found that in 2013, Memorial Hospital reported 16 requests for electronic medical records and claimed it provided all 16 within the required three business day period. The lawyers allege that on five occasions between April and December 2013, they received records in an electronic format only once and none of the records were issued within three business days, contradicting what the hospital reported. The pair claim to have found similar discrepancies with the other three hospitals.