National wound care provider accused of using 'superbills'

A national wound care provider, Healogics, is facing allegations from former employees that the company billed for unnecessary procedures, implicating clincs and hospital partners in 29 different states, according to the Jacksonville Business Journal.

The lawsuit, brought by two former technicians who worked for an Orlando clinic, and a staffer in Illinois, was unsealed last week. The whistleblowers allege that Healogics placed a "superbill" in the chart of each patient that listed all procedures and corresponding codes. and then pressured physicians to identify procedures that were never performed. The company allegedly overbilled for debridement procedures, hyperbaric oxygen treatment and transcutaneous oxygen measurement, according to Becker's Hospital Review.

A number of major hospitals that partnered with Healogics are included in the lawsuit, according to Becker's, including well-known systems like the Cleveland Clinic, Ascension Health and Tenet Healthcare. The lawsuit alleges that Healogics provided financial benchmarks to partnering hospitals that served as "corporate mandates." Physicians who didn't meet those benchmarks were forced out.

Additionally, two former hyperbaric technicians have filed a separate lawsuit alleging similar claims.

If true, the allegations would make waves in the fraud enforcement world, as wound care has not been a major target of fraud investigations. The case adds to concerns surrounding upcoding across a number of medical specialties, including ambulance services. In Florida, where Healogics is headquartered, officials have improved controls to root out fraud.

For more:
- read the Jacksonville Business Journal article
- here's the Beckers' Hospital Review article

Related Articles:
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Hospitals, ambulance companies share fraud liability burden
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