Ethical Physician Self-Referral

There is a situation at my hospital that is bothersome and I'd like to get some feedack.

In my community, we have an infectious disease doctor who has started his own IV infusion center at his office. Since opening this business, this doctor no longer uses home health for IV infusions. He does not give patients a choice and tells them they have to come to his office so that he can monitor their lab values and adjust their dosage. (something that can be done through home health/lab draws) If the patient insists on home health, he "fires" them as his patient. He has the patients come to his office three times a week. Some patients come in on stretchers, some with elderly caregivers exhausting themselves (and the patient) trying to get to the office. Patients with draining MRSA infected wounds are forced to take the city bus to his office. Although the patient is only receiving the infusion 3xW, he sends them home hooked up and after the infusion they remain hooked up at a TKO rate until their next appointment. Home health could teach the infusion to the caregiver and they would have much more freedom and comfort between infusions. If they have IV complications after hours, home health may not trouble shoot the IV, the patient is instructed to go to the ER. He refers most of these patients to home health, but only for wound care. So he gives them their IV and then they go home and wait for home health to come change their dressing. Apparently, the patient is still technically considered homebound if they are going to a "doctors appointment", so it is not medicare fraud. The sad thing is that it is very difficult for most of these patients and caregivers to go to his office. This doctor is willing, however to let the medical patient's have their IV's done by home health...just not the Medicare and private insurance patients. Discharge planners have commented on the large increase in patient's going home on IV antibiotics since he opened his business. Many complaints have been made to Administration, including the hospital attorney and Chief medical officer. The answer is always, "We will talk to him".

Sorry this is so long and I hope it's in the right forum. What do you guys make of this situation?