The former Maryland General Hospital in downtown Baltimore has agreed to pay $750,000 to settle a False Claims Act lawsuit in connection with overbilling for cardiac testing.
The settlement, announced by the United States Attorney for the District of Maryland and the Inspector General of the U.S. Department of Health & Human Services, resolves allegations that the acute care hospital overbilled cardiac perfusion studies from March 24, 2003, through Dec. 23, 2009, and failed to repay the amounts after senior financial managers became aware of the overpayments in 2007.
The allegations were brought to light by whistleblower Kenneth Cregger, a former senior financial analyst at the hospital, who will receive $119,728 from the settlement. Creeger worked in the finance department at Maryland General from 2001 to 2009, according to The Baltimore Business Journal.
Hospital officials told the Journal in a statement they agreed to settle the case "to avoid the uncertainty, inconvenience and expense of protracted litigation regarding these claims. ... The case centered around activities alleged to have occurred many years ago (2003-2009). Since that time period Maryland General has implemented an extensive compliance program."
The hospital had a name change in June and is now known as University of Maryland Medical Center Midtown Campus, a second location of University of Maryland Medical Center.
The Justice Department has recovered more than $10.7 billion since January 2009 in cases involving fraud against federal healthcare programs. The Justice Department's total recoveries in False Claims Act cases since January 2009 are more than $14.5 billion. But recent budget cuts at the Department of Health & Human Services Office of Inspector General may mean the government won't be able to monitor and investigate as many Medicare and Medicaid fraud and abuse allegations, FierceHealthcare previously reported.
"As OIG's budget resources decline, so do our enforcement and oversight activities," the OIG said in a document obtained by the Center for Public Integrity. The agency is losing about 400 employees, amounting to 20 percent of its staff. As a result, the OIG "will not be able to keep pace with … the expected need for growth to combat ongoing healthcare fraud."
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