Johns Hopkins Bayview Medical Center of Baltimore has agreed to pay $2.75 million to settle false claims charges. The claims asserted that patients suffered from malnutrition and acute respiratory failure to get higher reimbursements for them.
The claims sprung from a complaint by two Bayview employees, who said the hospital told them to review charts and upcode conditions for severity of two secondary diagnoses for certain patients, even if the condition wasn't present or treated. These allegations cover a period between July 1, 2005 and Feb. 28, 2007. The two patients who made the allegations are getting 20 percent of the total settlement, or $550,000.
Maryland hospitals get their reimbursement allocated through the state's Health Services Cost Review Commission, which sets rates for all providers in the state. Maryland is the only state in the country that sets rates for hospitals in the same manner as utilities are regulated in other states.
To learn more about this settlement:
- read this Modern Healthcare article (reg. req.)