Hospitals settle false claims, lunch money lawsuits

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Wahiawa (Hawaii) General Hospital will pay $451,428 to settle False Claims Act allegations stemming from two whistleblower lawsuits, the U.S. Department of Justice announced last week.

A doctor who worked at an outpatient clinic operated by Wahiawa General claimed the hospital improperly billed Medicare and Medicaid for services provided by resident doctors without the required supervision.

While the hospital did not admit liability, it agreed to pay an additional $75,000 in attorney's fees and costs to the attorneys who represented the doctor, the DOJ noted. The doctor who filed the whistleblower suits will receive $84,642.75 of the settlement payment.

According to the DOJ, the hospital made improper Medicare, Medicaid and TRICARE claims between April 1, 2008, and March 31, 2011, for services rendered by resident doctors participating in the Family Practice Residency Program who had insufficient documentation of required supervision by the program's teaching faculty. The hospital also improperly billed for services with codes that could not be confirmed by doctors' medical record entries.

Meanwhile, in another healthcare settlement, three New York hospitals agreed to pay $4.5 million over worker meal disputes, Syracuse.com reported.

St. Joseph's and Crouse hospitals in Syracuse and Faxton-St. Luke's in Utica each will pay $1.5 million to settle class action lawsuits accusing them of not paying hourly employees for work performed during meal breaks, before or after their scheduled shifts and in certain types of trainings.

The hospitals refute the claims, with St. Joseph's saying it decided to settle the case to avoid continued litigation and direct its efforts on patient care, the article noted.

St. Mary's Hospital in Madison, Wis., found itself in a similar situation earlier this summer, agreeing to pay $3.5 million to settle a lawsuit claiming the hospital failed to pay 1,400 nurses for meal breaks when they had to stay at the hospital on call.The hospital also decided to settle to avoid mounting litigation costs, FierceHealthcare previously reported.

To learn more:
- here's the DOJ announcement
- read the Syracuse.com article

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