The U.S. Department of Justice is suing Portland-based Martin’s Point Health Care and five other health care companies, claiming they knowingly accepted overpayments through a government program to provide care to veterans and their families.
The six defendants, Brighton Marine Health Center (Boston), CHRISTUS Health Services (Irving, Texas), Johns Hopkins Medical Services Corporation (Timonium, Maryland), Martin’s Point Health Care, Pacific Medical Center (Seattle) and St. Vincent’s Catholic Medical Centers of New York (New York), participated in the Uniformed Services Family Health Plan program.
The DOJ filed its complaint based on information from two whistleblowers at Martin’s Point — Jane Rollinson, a former interim chief financial officer, and Daniel Gregorie, a consultant to the CEO and board of directors who later served on the company’s board of trustees.
According to the complaint, in June 2012, the defendants learned that calculation errors had inflated the rates they had been paid in prior years. In response, they took steps to conceal the overpayments from the government and continued to submit invoices at the higher payment rates.
During discussions about rates for the subsequent year, the complaint alleges some of the defendants asked the government to continue paying them at the higher rates even though they knew rates were inflated by errors.
The complaint alleges the companies violated the False Claims Act.
In a statement released on Wednesday, Martin’s Point said it is “profoundly disappointed” in the DOJ’s decision to file the lawsuit about payments made more than 12 years ago based on errors the government itself made. The company said it “will vigorously defend itself.”
“The Government and Martin’s Point agreed on those rates. Now, the Government has alleged that it made forecasting errors when negotiating those rates more than 12 years ago,” the company wrote, adding, “Martin’s Point is confident that the evidence in this case will show that Martin’s Point met its obligations under the USFHP contract and did not receive an overpayment.”
The United States separately reached a settlement with defense department contractor Kennell & Associates Inc., a research and consulting firm based in Falls Church, Virginia. The contractor agreed to pay $779,951, plus interest, and payments based on its annual contract revenue and cash reserves through 2025. According to the DOJ, the settlement amount is based on Kennell and Associates’ ability to pay.
