Mayo Clinic agrees to $1.26M settlement over false billing claims
Earlier this month, the Mayo Clinic agreed to settle claims by the U.S. Department of Justice that the Rochester, Minn.-based healthcare system falsely billed Medicare and Medicaid for surgical pathology services that were not provided.
The settlement includes $263,000 that Mayo already voluntarily paid the government and an additional $1 million that still must be paid.
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According to Minnesota's U.S. Attorney's office, the suit was originally brought in 2007 under the "whistleblower" provisions of the False Claims Act. This statute allows private individuals to file civil actions on behalf of the United States and share in any recoveries obtained as a result. In this case, the government will pay $229,822 to four involved whistleblowers.
While the original complaint included three allegations – one in regards to surgical pathology billing issues and two about how the organization performs tissue pathology. According to a Mayo Clinic statement, the allegations involving tissue pathology were later dismissed. The complaint filed by the DOJ only dealt with the billing error issues.
"Upon discovering a billing error in 2007, Mayo promptly corrected it and voluntarily refunded $262,975 to the government. The error was identified and corrected long before Mayo became aware that a sealed complaint had been filed and before Mayo was notified that the DOJ was evaluating whether to become involved in the complaint," according to a Mayo Clinic press release.
According to the state attorney office's press release, Mayo had seven business days to make its $1 million settlement. Once the payment is processed, the federal government will pay $229,822 to the whistleblowers who participated in the qui tam action. Mayo will pay their attorney fees and legal expenses.
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"Billing government health programs for services never rendered – as Mayo allegedly did – is totally unacceptable," said Lamont Pugh, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General for the Chicago Region, which includes Minnesota, in a press release.
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