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Hospital-based agencies should review their processes, attorneys advise.<\/em><\/strong><\/span><\/p>\n A patient steering lawsuit filed by a freestanding home health agency against a hospital in Indiana will move forward, possibly paving the way for similar suits.<\/p>\n American Home Healthcare Services Inc.\u00a0<\/strong>in Jeffersonville is suing\u00a0Floyd Memorial Hospital<\/strong>, alleging the hospital steered patients to its own home health agency for the six counties they both serve, according to\u00a0American Home Healthcare Services Inc. v. Floyd Memorial Hospital and Health Services<\/em>.<\/p>\n Argument:<\/span>\u00a0<\/strong>American says\u00a0Floyd Home Health\u00a0<\/strong>received 64 percent of the home health discharges from the hospital in 2015, and receives 70 percent of them currently. The remaining 30 percent were spread among six HHAs, American contends.<\/p>\n American does concede \u201cthat it is listed on a pamphlet of available home health agencies furnished by Floyd Hospital to its patients,\u201d according to the March 5 ruling. But American \u201calleges that Floyd Hospital has installed mechanisms into the discharge planning process which increase the likelihood that Floyd Home Health will receive the most patient referrals,\u201d including \u201cthat physicians \u2026 must go through an extra step to select any home health provider besides Floyd Home Health due to the fact that the only two choices on the computer dropdown menu have been \u2018Floyd\u2019 and \u2018other,\u2019\u201d the ruling says. \u201cIf a patient wanted to use the \u2018other\u2019 category, the physician would have to go through an extra step to write down specifically which agency the patient chose.\u201d<\/p>\n In addition, \u201cAmerican alleges that based on several specific eyewitness reports from patients and their family, Floyd Hospital denied patient choice by referring patients to Floyd Home Health without offering any choices, advocating exclusively for Floyd Home Health, and\/or assigning patients to Floyd Home Health despite the patient\u2019s choice to use American\u2019s services,\u201d the ruling says.<\/p>\n Bottom line:<\/span>\u00a0<\/strong>\u201cAmerican claims that Defendants have been, and continue to be, in a position to starve the competition to a point at which competition will cease and Defendants will hold a monopoly with respect to supplying the relevant product in the relevant geographic market,\u201d the suit says. \u201cAmerican has asserted claims for attempted monopolization under Section 2 of the Sherman Act, as well as state law claims for tortious interference with existing and business relationships with patients.\u201d<\/p>\n Floyd asked the court to judge the case based on the pleadings and tried to argue with American\u2019s definition of the relevant geographic market, but \u201cthe district court held that American\u2019s theory based on Floyd Home Health\u2019s market share of Floyd Hospital\u2019s home health care referrals met the Seventh Circuit\u2019s benchmark of at least 50 percent for an attempted monopolization case,\u201d note attorneys\u00a0Bruce Sokler\u00a0<\/strong>and\u00a0Farrah Short\u00a0<\/strong>with\u00a0Mintz Levin Cohn Ferris Glovsky and Popeo\u00a0<\/strong>in analysis posted on the firm\u2019s website.<\/p>\n Floyd also countersued American for defamation, and tortious interference with existing and business relationships, the ruling notes. That occurred after Dr.\u00a0Abdul Buridi\u00a0<\/strong>sent an email to Floyd Hospital-employed physicians, \u201cwhich took issue with Floyd Hospital\u2019s referral process and implicitly warned that the physicians could be held responsible for violation of Stark and antitrust laws.\u201d<\/p>\n The court dismissed all but the defamation count, the ruling says.<\/p>\n Watch out for the possible impact of this case nationwide, says\u00a0Tom Boyd\u00a0<\/strong>with\u00a0Simione Healthcare Consultants\u00a0<\/strong>in Rohnert Park, California.<\/p>\n \u201cHonoring patients\u2019 right to freedom of choice continues to be a source of great concern for agencies that are not hospital-based,\u201d notes Washington, D.C.-based healthcare attorney\u00a0Elizabeth Hogue\u00a0<\/strong>in analysis. \u201cHospitals should expect more lawsuits based on violations of patients\u2019 right to freedom of choice,\u201d she stresses.<\/p>\n \u201cWhile not a decision on the merits, the district court\u2019s acceptance as plausible of a relevant market limited to a single hospital provides caution for health care providers with market power that refer within their own system,\u201d the Mintz Levin attorneys advise. \u201cWhile there are often clinical and economic reasons to retain patients within a health care system, if the scales appear too heavily weighted toward the \u2018home team,\u2019 at a minimum, expensive litigation like this one can result.\u201d<\/p>\n \u201cHealth care systems are well advised to have their processes and materials reviewed from an antitrust perspective,\u201d Sokler and Short recommend.<\/p>\n Source- SuperCoder<\/span><\/i><\/a><\/p>\n","protected":false},"excerpt":{"rendered":" Hospital-based agencies should review their processes, attorneys advise. A patient steering lawsuit filed by a freestanding home health agency against a hospital in Indiana will move forward, possibly paving the … Continue Reading →<\/a><\/p>\n","protected":false},"author":1,"featured_media":140,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18],"tags":[11,12,13,14],"class_list":["post-139","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-lawsuit","tag-home-care","tag-hospice","tag-ltc","tag-snf"],"_links":{"self":[{"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/posts\/139","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/comments?post=139"}],"version-history":[{"count":1,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/posts\/139\/revisions"}],"predecessor-version":[{"id":141,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/posts\/139\/revisions\/141"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/media\/140"}],"wp:attachment":[{"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/media?parent=139"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/categories?post=139"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/tags?post=139"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}