Alleged Medicare abuse costs Texas hospital $10M

After allegedly raising costs to receive larger payments from its Medicare outlier program, Houston-based Methodist Hospital has agreed to pay the U.S. government a fee of $10 million to settle the matter. Despite the resolution, Methodist does not have to, and is not admitting to any liability in the matter. 

Chief Legal Officer Mark Cantu thinks that the government cracked down on Methodist partly because it was on a list Congress received in 2003 of the hospitals that received the highest outlier payments nationally. Cantu, though, does not think that there was any fraud that took place in the case of Methodist; instead, he thinks that the Medicare fiscal intermediary is to blame for not updating the hospital's cost-to-charge ratio. 

"We firmly believe there was no fraud here," Cantu said. 

To learn more:
- here's the Modern Healthcare article

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