Catholic hospitals to pay overbilling settlements

Catholic Health Initiatives will pay the federal government $4.9 million to resolve allegations that one of its hospitals overbilled Medicare and Medicaid for unnecessary hospital admissions, The Baltimore Sun reported.

The settlement, announced yesterday, includes $4.6 million that will go the United States and $152,406 to the state of Maryland.

Catholic Health Initiatives is the former owner of St. Joseph Medical Center in Towson, Md., now under the University of Maryland Medical System. St. Joseph's is the site of the highly reported cases of kickbacks and unnecessary stents involving Mark Midei. Midei denies wrongdoing and says he is a scapegoat for the hospital and health system, the newspaper noted. However, Catholic Health noted the overbilling charges are separate from the cardiology case.

In a routine audit, St. Joseph's discovered the short-stay admissions from 2007 to 2009. The Justice Department alleges the hospital engaged in unnecessary admissions lasting one or two days and billed the federal health problems for reimbursements.

The settlement comes days after Catholic Health backtracked on its wrongful death defense of Colorado's St. Thomas More Hospital, in which the health system said it would no longer use the fetus-is-not-a-person legal argument. Although legally sound, the argument stands contrary to Catholic belief and is "morally wrong," according to the health system.

With the stenting case, an unnecessary admissions settlement and the wrongful death lawsuit, Catholic Health has its work cut out on legal matters.

Patrick Burns, spokesperson for the Taxpayers Against Fraud group, said executives from guilty facilities should be barred from federal programs.

"They should never be able to work for company that does business with Uncle Sam again. … That means as a medical administrator, you're done."

Meanwhile, another hospital is facing settlements for inappropriate billings. New York City-based Continuum Health Partners and its St. Luke's-Roosevelt Hospital yesterday agreed to a $2.3 million settlement with the state attorney general, resolving claims that they improperly billed Medicaid and Medicare. The Unites States alleged the hospital double billed out-patient services provided at its mental health clinics.

For more information:
- here's the DoJ statement on Catholic Health and the statement on St. Luke's
- read the Baltimore Sun article