Dartmouth-Hitchcock Medical Center of Lebanon, N.H., has agreed to pay more than $2.2 million to settle charges it improperly billed several federal healthcare programs, the U.S. Attorney for the District of Vermont announced Tuesday.
More than $80,000 will go to Vermont, $61,000 to New Hampshire, $1.5 million to the federal government and more than $334,000 will go to Thomas Prendergast, MD, a former Dartmouth-Hitchcock physician (and Vermont resident) who blew the whistle on the improper billing, reports the New Hampshire Union Leader.
Prendergast had reported that the hospital improperly billed federal programs--including Medicare, Medicaid, Veterans Affairs and the military's Tricare health insurance system--for services delivered by resident physicians in training who were unsupervised by more senior attending physicians, according to the Boston Globe.
While federal regulations and guidelines do permit physicians to bill for certain services provided by residents, those services must be performed while a physician is present and the medical record must include "appropriate documentation of the physician's presence," according a statement from the office of U.S. Attorney Tristram Coffin.
The primary source of the alleged billing problems was linked to Dartmouth-Hitchcock's anesthesiology department, including the pain clinic. In addition, the U.S. attorney's office also found similar billing problems in radiology. The office said the billing problems continued from 2001 to September 2007.
The medical center, while agreeing to pay the settlement, is denying any wrongdoing. However, it did say it has been working to improve its billing practices.
"We take documentation and billing practices very seriously and are determined to meet the highest standards of compliance and excellence in all aspects of our operations," Carl DeMatteo, MD, chief quality and compliance officer, tells the Boston Globe.
Feds launch new Medicare fraud outreach campaign
OIG asks for authority over Medicare fraud