Three HealthEast Hospitals Will Pay $2.28 Million For Fraudulent Policy
June 4, 2009 by casey
On Thursday, May 21, the Department of Justice announced a $2.28 million settlement between three HealthEast Care System hospitals and the United States. It was alleged that the hospitals, all of which are located in the Minneapolis/St. Paul area of Minnesota, performed kyphoplasties on an inpatient basis in order to increase their Medicare billings.
Kyphoplasties, which are minimally-invasive procedures used to treat osteoporosis-evoked spinal fractures, are typically performed on an outpatient basis. “Outpatient” procedures do not require admission to a hospital and can even be performed outside hospital facilities. By performing kyphoplasties on an inpatient basis, patients were unnecessarily admitted to the hospital and closely monitored before, during, and after the procedure.
In this fashion, the hospitals overcharged Medicare thousands of dollars for each kyphoplasty they performed.
“By keeping patients overnight, hospitals could seek greater reimbursement from Medicare and make much larger profits on kyphoplasty,” said Kathleen Mehltretter, Acting U.S. Attorney for the Western District of New York in Buffalo.
The whistleblower suit was brought under the False Claims Act, which permits private citizens to bring lawsuits on behalf of the United States and receive a portion of the proceeds of any settlement or judgment awarded against a defendant. The lawsuit was filed in 2008 in federal district court in Buffalo, N.Y. by Craig Patrick and Charles Bates. Mr. Patrick of Hudson, Wis., is a former reimbursement manager for Kyphon, and Mr. Bates was formerly a regional sales manager for Kyphon in Birmingham, Ala.
If you are witnessing fraud on the government, contact us by calling 800-377-1812 for strictly confidential advice from experienced counsel, with no fee obligation.
Regency Nursing and Rehabilitation Centers Will Pay $4 Million for Submitting False Claims
June 4, 2009 by casey
The Department of Justice released the settlement of a False Claims Act on Thursday, May 21, involving the Texas-based nursing home chain, Regency Nursing and Rehabilitation Center Inc. The company will pay $4 million to the United States to settle allegations that it submitted false claims to Medicaid and the Texas Medicaid program.
According to the case, Regency sought Medicare and Medicaid reimbursement for services that nursing home residents did not qualify for, were unnecessary, and were unsupported by required certification.
“With the number of Medicare and Medicaid beneficiaries increasing every year, we will take whatever action is necessary to make certain healthcare providers are reimbursed only for legitimate services provided to qualified beneficiaries,” said Tim Johnson, Acting U.S. Attorney for the Southern District of Texas.
If you are witnessing fraud on the government, contact us by calling 800-377-1812 for strictly confidential advice from experienced counsel, with no fee obligation.
Tennessee Hospitals Will Pay $8 Million To Settle Medicare Fraud Allegations
December 23, 2008 by casey
On December 1, the Memphis Business Journal reported that two Tennessee hospitals will pay $8 million to resolve Medicare fraud allegations. The U.S. Department of Justice argued that claims submitted by the Jackson-Madison County and Milan General Hospitals violated the Federal False Claims Act.
Between July 1997 and June 2002, Jackson-Madison County General Hospital was found to have submitted claims to Medicare that did not meet medical necessity and documentation requirements. The hospital will pay $2.6 million to resolve these charges.
Milan General was charged with improperly admitting Medicare patients into its psychiatric unit and billing Medicare for lengths of stay in units that exceeded coverage criteria. These offenses were reported to have happened between July 1999 and December 2003. Milan General will pay $5.3 million to settle the allegations.
“These settlements with Jackson Madison General and Milan General should serve as a warning to other health care providers who seek to defraud Medicare or any other federal health care programs,” said Lawrence Laurenzi, acting U.S. Attorney for the Western District of Tennessee.
If you are witnessing fraud on the government, contact us by calling 800-377-1812 for strictly confidential advice from experienced counsel, with no fee obligation.
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.
