Dubuis Health System and Southern Crescent Hospital for Specialty Care, Inc. (Southern Crescent) will pay the United States $8 million to resolve False Claims Act allegations dating back to 2003, the Department of Justice (DOJ) announced.
Dubuis manages long-term acute care hospitals in multiple states, including Southern Crescent in Riverdale, Ga., which is part of the CHRISTUS Health System. The settlement resolves allegations that between 2003 and 2009, Dubuis and Southern Crescent knowingly kept patients hospitalized beyond the time considered to be medically necessary, to increase their Medicare reimbursement and to maintain Southern Crescent's classification as a long-term acute care facility.
"Billing Medicare for patient care that is not necessary or appropriate contributes to the soaring costs of healthcare. This settlement demonstrates the Department of Justice's commitment to protect public funds and guard against abuse of the Medicare system," said Stuart F. Delery, acting assistant attorney general of the DOJ's civil division.
The allegations surfaced when Darlene Tucker, former administrator at Southern Crescent, filed a whistleblower complaint under the False Claims Act. As a result of this settlement, Tucker will receive $2.1 million of the United States' recovery.
Earlier this month in another false claims settlement case, 55 hospitals in 21 states agreed to pay the U.S. a total of more than $34 million to settle allegations that they submitted false claims to Medicare for kyphoplasty procedures.
"Whenever hospitals knowingly overcharge Medicare, critically needed resources are wasted and health costs are driven up," Daniel R. Levinson, inspector general for the U.S. Department of Health & Human Services, said in the announcement about the latter suit. "When taxpayers' dollars are threatened, OIG and its federal partners will take action."
- read the DOJ announcement