CoxHealth Will Pay $60 Million to Settle Charges of Overbilling Medicare
August 20, 2008 by casey
The U.S. Department of Justice reported on July 26, 2008, the settlement of a False Claims Act case against CoxHealth of Springfield, Missouri. Cox improperly billed and received payments from the Medicare trust fund, and agreed to pay $60 million to the United States in compensation. It was also alleged that Cox provided kickbacks to physicians of the for-profit Ferrell-Duncan Clinic Inc. If you are seeing fraud on the government, contact us by calling 800-377-1812 for strictly confidential advice from experienced counsel, with no fee obligation.
BlueCross Blueshield of Tennessee Agrees to $2.1 Million Settlement For Violating False Claims Act
August 20, 2008 by casey
On August 11, 2008, the Department of Justice announced a $2.1 million settlement to be paid by BlueCross BlueShield of Tennessee (BCBS-T) to the United States. BCBS-T, which operates as Riverbend Government Benefit Administrators, agreed to the settlement in response to allegations of its violating the False Claims Act.Â
The allegations against BCBS-T came in response to the company’s failure to modify the cost-to-charge ratios of hospitals in the state of New Jersey, for which it is the primary Medicare Part A Fiscal Intermediary (Part A Fiscal Intermediary’s are private insurance companies that manage Medicare claims). Because the cost-to-charge ratios were not conducted in a timely manner, many medical facilities were given excessive “outlier payments,†or supplementary reimbursements for unusually high-costing care, by Medicare.
“Today’s settlement demonstrates that the Justice Department will be vigilant in protecting the Medicare program from all who abuse it, including contractors that falsely bill for crucial tasks that they do not perform,” said Gregory G. Katsas, Assistant Attorney General of the Civil Division.
If you are seeing fraud on the government, contact us by calling 800-377-1812 for strictly confidential advice from experienced counsel, with no fee obligation.
