Baylor Health to pay $900K in double billing settlement

Baylor University Medical Center in Dallas has agreed to pay more than $900,000 to settle allegations that it submitted false claims to Medicare for radiation oncology services, the U.S. Justice Department announced yesterday.  

The settlement stemmed from a federal whistleblower lawsuit filed in 2010 by a Baylor radiation oncologist and a radiation therapist, The Dallas Morning News reported.

According to the government, Baylor double billed Medicare for procedures related to radiation treatment plans between 2006 and 2010. It also allegedly billed for higher-reimbursing services instead of less expensive ones, billed for procedures without supporting documentation and billed for radiation treatment without proof of physician supervision. 

With regard to doctor supervision, the suit accused Baylor of ignoring patient safety by not providing the required presence of a physician for complex radiation treatments, the Morning News noted.

Although Baylor has not admitted intentional wrongdoing, the medical center, along with Baylor Health Care System and HealthTexas Provider Network, decided to settle to avoid continuing litigation costs, according to the article.

Meanwhile, in another whistleblower suit this month, Northwestern Memorial Hospital and Northwestern University faced allegations of double billing patient care for NIH-funded clinic research trials.

These suits come as the government begins to crack down on hospital billing practices and make sure hospitals are compliant with Medicare billing rules.

For more:
- here's the DOJ statement
- read the Dallas Morning News article