Tuesday, April 5, 2011

Rex Healthcare To Pay $1.9 Million To Resolve Kyphoplasty-Related FCA Allegations

Financial Fraud Law is reporting that "Rex Healthcare, a 655 bed hospital in Raleigh, N.C., has agreed to pay the United States $1.9 million, plus interest, to settle allegations that it submitted false claims to Medicare. The government alleged that the hospital routinely submitted claims to Medicare for a variety of minimally-invasive procedures during the period 2004 through 2007, which the hospital classified as inpatient admissions in order to increase its reimbursement from Medicare, despite the absence of medical necessity justifying the more expensive inpatient admissions."  

Click here for the DoJ press release.

It is fairly easy for a hospital to commit this type of fraud.  I blogged earlier how CMS is trying to crack down on this type of fraud.  But it's almost imposbile given our third-party reimbursement system is based upon honesty and not everyone is honest.

No comments:

Post a Comment