One of Kentucky's largest healthcare systems, Norton Healthcare, agreed last week to settle allegations that it overbilled Medicare by paying $782,842 to the federal government, the U.S. Attorney for the Western District of Kentucky and the Office of Inspector General of the Department of Health and Human Services announced late last week.
Under the settlement agreement, Norton was charged with inappropriately submitting additional charges to Medicare for wound care, infusion, and radiation oncology services performed in an outpatient setting.
In particular, Norton was charged with submitting additional charges for separate evaluation and management services performed for patients in the outpatient settings. These charges should have been included in the basic rate, prosecutors said.
This alleged overbilling covered the five-year period between January 1, 2005, and February 26, 2010.
Norton, a not-for-profit organization that includes five hospitals, five outpatient centers, and 12 immediate care centers in the Louisville area, said the settlement was not an admission to the government's claims.
The settlement is about twice the amount that Norton allegedly overbilled Medicare, said Stephanie Collins, spokeswoman for the U.S. attorney's office in Louisville. She said the alleged overbilling was discovered through a search by AdvanceMed, a Medicare contractor that looks for fraud in claims data, reports the Louisville Courier-Journal.
For more information:
- see the U.S. Attorney's announcement
- view the Louisville Courier-Journal article
- see the AP article