DOCTORS GROUP SETTLES IN WHISTLE-BLOWER CASE.

Byline: Jennifer Hamm Staff Writer

A physicians group associated with Glendale Adventist Medical Center paid $250,000 to resolve a whistle-blower lawsuit claiming that doctors overbilled Medi-Cal for delivering babies, officials said Wednesday.

The settlement resolves allegations against the Perinatal Medical Group and Dr. Hugo Riffel, who directed the hospital's obstetrics/gynecology residency program, said a spokesman for the U.S. Attorney's Office. They were accused by Dr. Caroline Pieszak of billing Medi-Cal for routine vaginal deliveries by the hospital's residents, as if they were performed by fully licensed physicians.

``She thought it was wrong that residents were delivering babies there without the presence of an attending physician,'' said Pieszak's attorney, Barbara Hensleigh.

For Medi-Cal reimbursement, attending physicians, who supervise residents in their training, are required to be there during labor.

With the payment made last week, the U.S. Attorney's Office released the medical group and Riffel from potential fraud claims. The group and Riffel did not admit wrongdoing.

Pieszak could receive up to 25 percent of the settlement for bringing the case to prosecutors' attention. Now practicing medicine in Westlake Village, she was a resident under Riffel in 1995 and 1996 and claimed that thousands of false claims were filed.

But Riffel said attending physicians were always in the delivery room or at least nearby. He said Medi-Cal regulations are unclear, and that he did not believe that he was breaking the law.

``The services were furnished in an appropriate way,'' Riffel said. ``There was never a question of quality of care or professional behavior.''

After running the residency program for 20 years, Riffel left last fall. Pieszak is still pursuing the claim against the hospital itself, which has not been resolved. The U.S. attorney declined to intervene in that portion of the lawsuit.