Saint Michael's Medical Center to pay $450,000 to settle false claims allegations
Settlement resolves allegations they falsely billed Medicare and Medicaid for medically unnecessary cardiac procedures.
Saint Michael's Medical Center in Newark, New Jersey will pay almost half a million dollars to resolve allegations they falsely billed Medicare and Medicaid for medically unnecessary cardiac procedures over the course of six years, the U.S. Attorney's office announced.
The hospital will pay $450,000 per a settlement reached as part of a whistleblower lawsuit. The U.S. Attorney's office did not say who filed the suit or what the whistleblower might receive for their portion of the recovery, as allowed by the False Claims Act.
The allegations stated that from Jan. 1, 2009 to Jan. 1, 2015, Saint Michael's allegedly submitted claims for percutaneous coronary interventions, catheterizations, and stents performed in its cardiac catheterization lab that were not medically necessary.
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Rules governing Medicare and Medicaid stipulate that providers should provide services only when they are medically necessary. Additionally, government healthcare programs should only authorize payment for services that are "reasonable and medically necessary", the DOJ said.
The investigation was conducted jointly by the FBI, and the U.S. Department of Health and Human Services Office of the Inspector General.
Twitter: @BethJSanborn
