Hospitals in Trouble for Improperly Billing Medicare and Medicaid Health Care Programs

St. Michael’s Medical Center in Newark, New Jersey recently resolved allegations with the Department of Justice that it falsely billed Medicare and Medicaid for medically unnecessary cardiac procedures.  Specifically, claims were allegedly submitted for unnecessary services that included percutaneous coronary interventions, catheterizations, and stents performed in its cardiac catheterization lab.

A Nolan Auerbach and White client brought a qui tam False Claims Act case against Dignity Health, with similar allegations, inter alia, that thirteen (13) of Dignity’s Hospitals, from January 1, 2006 through December 31, 2010, knowingly submitted or caused to be submitted claims for payment to the Federal Healthcare Programs for scheduled cardiovascular procedures, billing these services as inpatient procedures when they should have been billed as outpatient procedures. Dignity Health agreed to pay nearly $37 million to resolve Ms. Hawkins’ qui tam lawsuit.

Hospital fraud inevitably continues. If you have knowledge of hospital fraud we encourage you to contact us for a strictly confidential consultation.