Vaughan Regional Medical Center in Selma agrees to settlement in whistleblower lawsuit

Vaughan Regional Medical Center in Selma has agreed to pay $1.45 million in a lawsuit that alleged that physicians at the center violated the False Claims Act, announced U.S. Attorney Richard Moore.

According to the announcement, emergency room physicians Dr. Phillip Alan Hicks and Dr. Sai S. Namburu agreed to the settlement after a lawsuit was filed by Dr. Samuel Clemmons, who will receive $275,000.

Clemmons’ suit alleged that residents that were not fully licensed were covering shifts at Vaughan’s Emergency Department. He also said that he spoke with Vaughan and the subsidiary, LifePoint, about this but that “no action was taken.”

“The significance of this case highlights the responsibilities of medical professionals and healthcare administrators to protect their patients from harm, and to prevent fraud against any federal health insurance program during the performance of their duties,” Moore commented in the press release.

“The citizens of the Selma community are entitled to quality healthcare administered by fully licensed physicians, and actions taken to put patient care in jeopardy and to circumvent state and federal law will not be tolerated.”

Moore’s announcement said that an investigation was conducted and that the center hired residents from the UAB-Selma Family Medicine Residency Program to treat patients between mid-2009 to March 31 in 2012.

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The investigation found that residents were paid $50 an hour in cash to treat patients though they were not fully licensed and credentialed physicians alongside emergency room physicians who were licensed and were “also paid an extra $50 per hour to co-sign the residents’ charts,” the announcement stated.

Medical records were allegedly falsified and false claims were submitted to Medicare though the services were provided by residents who were not licensed physicians.

“Patients expect treatment by fully qualified medical professionals, and taxpayers should never be paying for healthcare provided fraudulently by an unlicensed physician–as alleged in this case,” commented Derrick L. Jackson, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services.

“We will aggressively work with our law enforcement partners in pursuit of those who would defraud government health programs and the individuals they serve.”

Vaughan CEO David McCormick said, “Vaughan disputes the allegations in the lawsuit and the government’s investigation and believes that it has acted in compliance with applicable laws and regulations pertaining to its Emergency Department at all relevant times. The portion of the settlement paid by Vaughan stems from alleged conduct by a third-party staffing company whose contractual relationship with Vaughan ended in 2012. The decision to enter into the settlement agreement is based solely on Vaughan’s desire to avoid the cost and distraction of litigation and to allow Vaughan to focus on its mission of serving the healthcare needs of the residents of Selma and surrounding communities.”