Medical Center-Navicent Health pays $20 million to settle claims it falsely billed Medicare
Feds say hospital billed Medicare for short-stay inpatient visits that should have been submitted as outpatient stays.
Macon, Georgia-based Medical Center-Navicent Health has agreed to pay $20 million to settle allegations that between 2004 and 2008 it billed Medicare for short-stay inpatient visits that should have been submitted as outpatient stays, which come with lower reimbursements.
The alleged abuse occurred when the facility was called the Medical Center of Central Georgia. It was renamed last year.
Hospital administrators in a statement said they agreed to the settlement to avoid a costly litigation.
[Also: Running list of notable 2015 healthcare frauds]
As part of the deal, the hospital will put employees through compliance training and said it will retain an outside reviewer to report on the hospital's claim processes.
“We take compliance very seriously and continue to strengthen our already strong compliance policies and procedures," CEO Ninfa M. Saunders said in a statement.
The hospital pointed to industry-wide confusion that health systems face when differentiating between short stays and outpatient visits, but the U.S. Department of Justice said such alleged fraud is a serious drain on Medicare.
Follow Healthcare Finance on Twitter and LinkedIn.
“Overcharging the government for medical services wastes our country’s limited healthcare resources,” acting U.S. Attorney John Horn said in a statement from the DOJ. “When a provider inflates its billings, we will aggressively seek to recover the overcharges under the False Claims Act.”
Twitter: @HenryPowderly
