Wayne Medical Center, part of Tennessee's Maury Regional Medical Center, has agreed to pay $883,451 to settle self-reported allegations of improper Medicare billing, the state U.S. Attorney's Office announced yesterday.
The hospital's compliance program discovered the false claims, which led to an investigation of the hospital's billing for ambulance transport as part of its emergency medical services.
According to the settlement, between 2004 and 2009, the hospital submitted Medicare claims for ambulance services that were not medically necessary, lacked necessary certification or signatures and had incorrect transport level assignment.
Self-reporting the overbilling allegations allowed Wayne Medical Center to avoid continuing litigation costs and thousands of dollars in potential fines under the False Claims Act, the Nashville Business Journal reported.
"Today's announced settlement is another example of the benefit to providers of self-reporting billing issues directly to the United States Attorney's Office," U.S. Attorney Jerry E. Martin said in a statement. "By doing the right thing and coming forward, they were treated fairly and were able to quickly and efficiently put this matter behind them."
The hospital is following the footsteps of Maury Regional Medical Center, which self-reported Medicare billing violations last year and agreed to a $3.6 million settlement, the Business Journal noted.
Tennessee's Memorial Health Care System also made a self-disclosure for problematic physician leases. The system settled with the government for $1.3 million, rather than winding up with a corporate integrity agreement.