$450K Medicare Settlement to US Government for Allegations Under False Claims Act
A Connecticut healthcare facility agreed to a $450,000 settlement to the U.S. government recently for allegedly violating the federal False Claims Act by falsifying and then covering up billing records regarding Medicare/Medicaid payments.
New York City criminal lawyers at Bernfeld, DeMatteo & Bernfeld, L.L.P. have assisted the SettlementBoard editorial team in identifying topics of importance to readers of this blog.
It was revealed in Myrecordjournal.com in Masonicare to pay nearly $450,000 in Medicare/Medicaid settlement that Masonicare Health Center of Wallingford had allegedly falsified billing codes in administering injections of leuprolide acetate to Medicare and Medicaid patients.
The drug, also known as Lupron, is used to treat prostate cancer in men and fibroids and endometriosis in women. Medicare/Medicaid reimburses at a higher rate if the drug is used on women.
The government in its suit against Masonicare alleged that the facility routinely billed for the female-related code despite injections given to men. Further, the government maintained that Masonicare had discovered the discrepancy in 2009 but failed to notify the government or offer to reimburse it for the overpayments.
The False Claims Act provides for triple damages and civil penalties for liability under the act if a facility fails to notify and promptly reimburse the government for overpayments. The facility agreed to pay $447,776 for its actions between January 1, 2001, to May 31, 2010.
The amount that Masonicare was overpaid was not disclosed. The facility also denied liability but agreed to the settlement to end the litigation.
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