Despite its having engaged in a massive Medicare scam costing the federal government at least $630 million, St. Barnabas Health Care System did not prevent other hospitals from getting fair reimbursement.
That's the conclusion of a federal judge, who ruled that despite the fraud, St. Barnabas had not engaged in racketeering. Two small hospitals in Maine and Colorado filed the suit, alleging St. Barnabas' over billing was so extreme it distorted CMS's Medicare reimbursement formulas nationwide. (St. Barnabas had been involved in a scheme to inflate reported costs for its most expensive procedures and thereby increase billings.) The hospitals contended St. Barnabas' actions led to thousands of facilities losing more than $500 million in federal money. The judge, however, ruled the government was the only victim of the health system's actions. When St. Barnabas agreed to repay $265 million, even that damage was mitigated.
To find out more about the case:
- read this article in The New York Times (reg. req.)
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